Elbasvir/grazoprevir for patients with chronic hepatitis C virus genotype 1b infection in China: an economic evaluation_Chinese Journal of Evidence-Based Medicine

Authors：

CHEN Pingyu , LI Hongchao ,  MA Aixia

School of International Pharmacuetical Business, China Pharmacuetical University, Nanjing, 211198, P.R.China;

Corresponding author：

MA Aixia, Email: ma86128@sina.com

Keywords：

Chronic hepatitis C; Cost utility analysis; Markov model

DOI：

10.7507/1672-2531.201805080

Video：

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Objectives To determine the health benefit of elbasvir/grazoprevir versus peginterferon combing with ribavirin (PR regimen) for Chinese chronic hepatitis C patients with genotype 1b infection. Methods Markov cohort state-transition models were constructed to conduct cost utility analysis. Sensitivity analyses were performed based on base-case analysis. Results Elbasvir/grazoprevir was dominant versus PR, resulting in higher QALYs and lower costs for both noncirrhotic patients (13.867 5 QALYs, 82 090.82 RMB vs. 12.696 2 QALYs, 122 791.55 RMB) and cirrhotic patients (12.841 6 QALYs, 225 807.70 RMB vs. 8.892 4 QALYs, 326 545.01 RMB). Elbasvir/grazoprevir was economically dominant in nearly 100% among all patients within the range of threshold from 0 to 161 805 RMB/QALY. Conclusions Elbasvir/grazoprevir was dominant in treatment of genotype 1b chronic hepatitis C infection in China.

Citation： CHEN Pingyu, LI Hongchao, MA Aixia. Elbasvir/grazoprevir for patients with chronic hepatitis C virus genotype 1b infection in China: an economic evaluation. Chinese Journal of Evidence-Based Medicine, 2018, 18(12): 1352-1358. doi: 10.7507/1672-2531.201805080 Copy

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3.	Duan ZP, Zhou HY, Duan C, et al. Survey of treatment costs to hepatitis C in China. Value Health, 2014, 17(7): A805.
4.	中国药物经济学评价指南课题组, 刘国恩, 胡善联, 等. 中国药物经济学评价指南 (2011 版). 中国药物经济学, 2011, 6(3): 6-48.
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9.	El-Kamary SS, Jhaveri R, Shardell MD. All-cause, liver-related, and non-liver-related mortality among HCV-infected individuals in the general US population. Clin Infect Dis, 2011, 53(2): 150-157.
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14.	Fattovich G, Giustina G, Degos F, et al. Morbidity and mortality in compensated cirrhosis type C: a retrospective follow-up study of 384 patients. Gastroenterology, 1997, 112(2): 463-472.
15.	孙雨欣, 刘永军, 刘通. 宫颈癌疫苗用于 18–25 岁中国女性预防宫颈癌的药物经济学评价. 中国循证医学杂志, 2017, 17(1): 102-107.
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17.	Zeuzem S, Ghalib R, Reddy KR, et al. Grazoprevir-Elbasvir combination therapy for treatment-naive cirrhotic and noncirrhotic patients with chronic hepatitis C virus genotype 1, 4, or 6 infection: a randomized trial. Ann Intern Med, 2015, 163(1): 1-13.
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19.	李权润, 张长江, 熊瑜琳, 等. 干扰素联合利巴韦林治疗慢性丙型肝炎长期随访中的复发及其影响因素. 中华肝脏病杂志, 2012, 20(5): 353-356.
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24.	Warren E, Wright A, Jones B. Cost-effectiveness of telaprevir in patients with genotype 1 hepatitis C in Australia. Value Health, 2014, 17(8): 792-800.
25.	Wei L, Hu S, Hou J, et al. A novel estimation of the impact of treatment with Entecavir on long-term mortality, morbidity, and health care costs of chronic hepatitis B in China. Value Health Reg Issues, 2013, 2(1): 48-56.
26.	Thein HH, Krahn M, Kaldor JM, et al. Estimation of utilities for chronic hepatitis C from SF-36 scores. Am J Gastroenterol, 2005, 100(3): 643-651.
27.	Levy AR, Kowdley KV, Iloeje U, et al. The impact of chronic hepatitis B on quality of life: a multinational study of utilities from infected and uninfected persons. Value Health, 2008, 11(3): 527-538.
28.	贾继东, 魏来, 庄辉. 关于加快根治丙型肝炎药物审评注册及降低价格的建议. 临床肝胆病杂志, 2016, 32(5): 825.
29.	Ferreira VL, Assis Jarek NA, Tonin FS, et al. Safety of interferon-free therapies for chronic hepatitis C: a network meta-analysis. J Clin Pharm Ther, 2016, 41(5): 478-485.

1. WHO. Hepatitis C fact sheet. Available at: http://www.who.int/mediacentre/factsheets/fs164/en/.
2. 中华医学会肝病学分会中华医学会感染病学分会. 丙型肝炎防治指南 (2015 年更新版). 临床肝胆病杂志, 2015, 31(12): 1961-1979.
3. Duan ZP, Zhou HY, Duan C, et al. Survey of treatment costs to hepatitis C in China. Value Health, 2014, 17(7): A805.
4. 中国药物经济学评价指南课题组, 刘国恩, 胡善联, 等. 中国药物经济学评价指南 (2011 版). 中国药物经济学, 2011, 6(3): 6-48.
5. 中华人民共和国国家统计局国家数据查询系统. Available at: http://data.stats.gov.cn/easyquery.htm?cn=C01.
6. D’Ambrosio R, Aghemo A, Rumi MG, et al. A morphometric and immunohistochemical study to assess the benefit of a sustained virological response in hepatitis C virus patients with cirrhosis. Hepatology, 2012, 56(2): 532-543.
7. 中华人民共和国国家统计局国家数据查询系统. Available at:http://www.stats.gov.cn/tjsj/pcsj/rkpc/6rp/indexch.htm.
8. Veldt BJ, Saracco G, Boyer N, et al. Long term clinical outcome of chronic hepatitis C patients with sustained virological response to interferon monotherapy. Gut, 2004, 53(10): 1504-1508.
9. El-Kamary SS, Jhaveri R, Shardell MD. All-cause, liver-related, and non-liver-related mortality among HCV-infected individuals in the general US population. Clin Infect Dis, 2011, 53(2): 150-157.
10. Manos MM, Darbinian J, Rubin J, et al. The effect of hepatitis C treatment response on medical costs: a longitudinal analysis in an integrated care setting. J Manag Care Pharm, 2013, 19(6): 438-447.
11. Chhatwal J, Kanwal F, Roberts MS, et al. Cost-effectiveness and budget impact of hepatitis C virus treatment with sofosbuvir and ledipasvir in the United States. Ann Intern Med, 2015, 162(6): 397-406.
12. Thein HH, Yi Q, Dore GJ, et al. Estimation of stage-specific fibrosis progression rates in chronic hepatitis C virus infection: a meta-analysis and meta-regression. Hepatology, 2008, 48(2): 418-431.
13. Rao HY, Li H, Chen H, et al. Real-world treatment patterns and clinical outcomes of HCV treatment-naive patients in China: an interim analysis from the CCgenos study. J Gastroenterol Hepatol, 2017, 32(1): 244-252.
14. Fattovich G, Giustina G, Degos F, et al. Morbidity and mortality in compensated cirrhosis type C: a retrospective follow-up study of 384 patients. Gastroenterology, 1997, 112(2): 463-472.
15. 孙雨欣, 刘永军, 刘通. 宫颈癌疫苗用于 18–25 岁中国女性预防宫颈癌的药物经济学评价. 中国循证医学杂志, 2017, 17(1): 102-107.
16. Chen GF, Wei L, Chen J, et al. Will Sofosbuvir/Ledipasvir (Harvoni) be cost-effective and affordable for Chinese patients infected with hepatitis C virus? An economic analysis using real-world data. PLoS One, 2016, 11(6): e0155934.
17. Zeuzem S, Ghalib R, Reddy KR, et al. Grazoprevir-Elbasvir combination therapy for treatment-naive cirrhotic and noncirrhotic patients with chronic hepatitis C virus genotype 1, 4, or 6 infection: a randomized trial. Ann Intern Med, 2015, 163(1): 1-13.
18. Kwo P, Gane EJ, Peng CY, et al. Effectiveness of Elbasvir and Grazoprevir combination, with or without Ribavirin, for treatment-experienced patients with chronic hepatitis C infection. Gastroenterology, 2017, 152(1): 164-175.
19. 李权润, 张长江, 熊瑜琳, 等. 干扰素联合利巴韦林治疗慢性丙型肝炎长期随访中的复发及其影响因素. 中华肝脏病杂志, 2012, 20(5): 353-356.
20. Ahmed H, Abushouk AI, Menshawy A, et al. Meta-analysis of Grazoprevir plus Elbasvir for treatment of hepatitis C virus genotype 1 infection. Ann Hepatol, 2018, 17(1): 18-32.
21. van der Meer AJ, Veldt BJ, Feld JJ, et al. Association between sustained virological response and all-cause mortality among patients with chronic hepatitis C and advanced hepatic fibrosis. JAMA, 2012, 308(24): 2584-2593.
22. Morgan RL, Baack B, Smith BD, et al. Eradication of hepatitis C virus infection and the development of hepatocellular carcinoma: a meta-analysis of observational studies. Ann Intern Med, 2013, 158(5 Pt 1): 329-337.
23. Townsend R, McEwan P, Kim R, et al. Structural frameworks and key model parameters in cost-effectiveness analyses for current and future treatments of chronic hepatitis C. Value Health, 2011, 14(8): 1068-1077.
24. Warren E, Wright A, Jones B. Cost-effectiveness of telaprevir in patients with genotype 1 hepatitis C in Australia. Value Health, 2014, 17(8): 792-800.
25. Wei L, Hu S, Hou J, et al. A novel estimation of the impact of treatment with Entecavir on long-term mortality, morbidity, and health care costs of chronic hepatitis B in China. Value Health Reg Issues, 2013, 2(1): 48-56.
26. Thein HH, Krahn M, Kaldor JM, et al. Estimation of utilities for chronic hepatitis C from SF-36 scores. Am J Gastroenterol, 2005, 100(3): 643-651.
27. Levy AR, Kowdley KV, Iloeje U, et al. The impact of chronic hepatitis B on quality of life: a multinational study of utilities from infected and uninfected persons. Value Health, 2008, 11(3): 527-538.
28. 贾继东, 魏来, 庄辉. 关于加快根治丙型肝炎药物审评注册及降低价格的建议. 临床肝胆病杂志, 2016, 32(5): 825.
29. Ferreira VL, Assis Jarek NA, Tonin FS, et al. Safety of interferon-free therapies for chronic hepatitis C: a network meta-analysis. J Clin Pharm Ther, 2016, 41(5): 478-485.

Chinese Journal of Evidence-Based Medicine

Elbasvir/grazoprevir for patients with chronic hepatitis C virus genotype 1b infection in China: an economic evaluation

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