1Section of Gastroenterology, Di.Bi.M.I.S., University of Palermo, Italy.
2Department of Economic, Business and Statistic Science (SEAS), University of Palermo, Palermo, Italy.
3Division of Infectious and Tropical Diseases, Foundation IRCCS San Matteo Hospital, University of Pavia, Italy.
4Gastroenterology Unit, Catholic University, Rome, Italy.
5Department of Internal Medicine, A.O. Fatebenefratelli e Oftalmico, Milan, Italy.
6Section of Gastroenterology, Di.Bi.M.I.S., University of Palermo, Italy. Electronic address: firstname.lastname@example.org.
We assessed the cost-effectiveness of boceprevir-based triple therapy compared to peginterferon alpha and ribavirin dual therapy in untreated patients with genotype 1 chronic hepatitis C; patients were discriminated according to the combination of baseline plus on-treatment predictors of boceprevir-based triple therapy.
Cost-effectiveness analysis performed according to data from the available published literature. The target population was composed of untreated Caucasian patients, aged 50 years, with genotype 1 chronic hepatitis C, and these were evaluated over a lifetime horizon by Markov model. The study was carried out from the perspective of the Italian National Health Service. Outcomes included discounted costs (in euro, at 2013 value), life-years gained, quality-adjusted life year, and incremental cost-effectiveness ratio. The robustness of the results was evaluated by multivariable probabilistic sensitivity analyses.
According to the baseline predictors of sustained virological response (genotype 1b, low viral load, fibrosis F0-F3, and body mass index) and the 1Log drop of HCV-RNA after the dual therapy lead-in period, boceprevir was cost-effective in different patient profiles.
In untreated genotype 1b chronic hepatitis C patients, the cost-effectiveness of boceprevir-based triple therapy widely ranges according to different profiles of sustained virological response predictors, allowing optimization and personalization of triple therapy.