Original scientific paper
https://doi.org/10.3325/cmj.2016.57.582
Incremental cost-effectiveness pharmacoeconomic assessment of hepatitis C virus therapy: an approach for less wealthy members of the common market
Diana Mance
orcid.org/0000-0001-6746-8693
; 1Department of Physics, University
Davor Mance
orcid.org/0000-0002-6206-2464
; Faculty of Economics, University of Rijeka, Rijeka, Croatia
Dinko Vitezić
orcid.org/0000-0002-6295-6580
; School of Medicine, University of Rijeka, Rijeka, Croatia
Abstract
Aim To develop a new method of health-economic analysis
based on a marginal approach.
Methods We tested the research hypothesis that a detailed
comparative a priori incremental cost-effectiveness analysis
provides the necessary input for budget impact analysis
about the proper order of introduction of new therapies,
and thus maximizes the cost-effectiveness bounded
by the total budget constraint. For the analysis we chose a
combination therapy for the treatment of hepatitis C virus
(HCV) genotype 1 (GT1) infection, which was approved by
the European Medicine Agency in 2015. We used the incremental
cost-effective approach to assess the increase
in the percentage of patients achieving sustained virological
response (SVR) and the expenditure per additional SVR
modulated by the new therapy’s market entrance dynamics.
Patient subpopulations were differentiated by their response
to previous treatment, presence of cirrhosis, and
HCV GT1 subtype. Final parameters were estimated by
Monte Carlo simulations.
Results The new combination therapy had high efficacy,
shorter duration, and was better tolerated than alternative
interventions. The research hypothesis was confirmed:
gradual introduction of the new therapy on the market,
based on a priori incremental cost-effectiveness analysis,
would result in average increase in successfully treated patients
by 20%-40%, while additional costs would approximately
be between 8%-40%, ie, €21 000-52 000 per additional
patient achieving SVR.
Conclusion We showed the new combination therapy
to be cost-effective for certain patient subpopulations,
especially for experienced cirrhotic HCV GT1 patients. Results
of the analysis are in agreement with the latest recommendations
for HCV patients’ treatment in Croatia. This
economic evaluation could serve as a starting point for
negotiations between pharmaceutical industry and insurance
companies.
Keywords
Hrčak ID:
181398
URI
Publication date:
15.12.2016.
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