Thorlund Kristian, Druyts Eric, El Khoury Antoine C, Mills Edward J
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton.
Clinicoecon Outcomes Res. 2012;4:349-59. doi: 10.2147/CEOR.S37205. Epub 2012 Nov 16.
Boceprevir and telaprevir have recently showed dramatically better treatment outcomes than conventional PEGylated interferon plus ribavirin for the treatment of hepatitis C virus genotype 1, but the average cost per patient is unknown.
In the UK context, we performed a budget impact analysis to estimate the average per patient cost of adding boceprevir or telaprevir to PEGylated interferon plus ribavirin therapy. We considered both standard-duration therapy and response-guided therapy regimens of boceprevir and telaprevir for treatment-naïve and treatment-experienced patients. Our model utilized monthly discontinuation rates. We built a Bayesian Markov model to account for uncertainty associated with the clinical input and cost data.
The total average cost of response-guided therapy with boceprevir is £22,850 and £25,060 for treatment-naïve and treatment-experienced patients, respectively. By comparison, the total average cost of response-guided therapy with telaprevir was £29,930 and £31,880 for treatment-naïve and treatment-experienced patients, respectively, whereas the total average cost of standard-duration boceprevir is £34,680 and £34,350 and for telaprevir was £32,530 and £31,680 for treatment-naïve and treatment experienced patients, respectively.
Our results demonstrate that response-guided therapy with boceprevir is notably less costly than response-guided therapy with telaprevir. Our results also suggest that the standard treatment duration of boceprevir is slightly more costly than the standard treatment duration of telaprevir.
最近研究显示，对于丙型肝炎病毒1型的治疗，波西普韦和特拉匹韦比传统的聚乙二醇化干扰素联合利巴韦林疗法具有显著更好的治疗效果，但每位患者的平均费用尚不清楚。
在英国的背景下，我们进行了预算影响分析，以估计在聚乙二醇化干扰素联合利巴韦林治疗中添加波西普韦或特拉匹韦的每位患者平均费用。我们考虑了波西普韦和特拉匹韦针对初治患者和经治患者的标准疗程疗法和应答指导疗法方案。我们的模型采用了每月停药率。我们构建了一个贝叶斯马尔可夫模型，以考虑与临床输入和成本数据相关的不确定性。
对于初治患者和经治患者，采用波西普韦的应答指导疗法的总平均费用分别为22,850英镑和25,060英镑。相比之下，对于初治患者和经治患者，采用特拉匹韦的应答指导疗法的总平均费用分别为29,930英镑和31,880英镑，而对于初治患者和经治患者，波西普韦标准疗程的总平均费用分别为34,680英镑和34,350英镑，特拉匹韦标准疗程的总平均费用分别为32,530英镑和31,680英镑。
我们的结果表明，波西普韦的应答指导疗法的费用明显低于特拉匹韦的应答指导疗法。我们的结果还表明，波西普韦的标准治疗疗程的费用略高于特拉匹韦的标准治疗疗程。
