Alavian Seyed Moayed, Nikfar Shekoufeh, Kebriaeezadeh Abbas, Lotfi Farhad, Sanati Ehsan, Rezaei Hemami Mohsen, Keshavarz Khosro
Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, IR Iran.
Iran Red Crescent Med J. 2016 Oct 2;18(11):e37094. doi: 10.5812/ircmj.37094. eCollection 2016 Nov.
Despite the introduction of new drug regimens with high effectiveness for the hepatitis C virus (HCV) patients, especially in HCV genotype 1, no cost-effectiveness study on the selection of the superior drug strategy in Iran has been conducted yet.
This study is aimed to assess the cost-effectiveness of the three drug regimens of pegylated interferon and ribavirin (PR), sofosbuvir (SOF) + PR and ledipasvir and sofosbuvir (LDV/SOF) in patients with HCV genotype 1 in Iran in the year 2014.
A Markov micro-simulation model was used to evaluate the cost-effectiveness of the three drug strategies for a cohort of 10000 patients. Quality-adjusted life-years (QALYs) were extracted from published studies. Cost data was estimated through the review of medical records and obtaining experts opinion.
The results showed that the SOF + PR drug compared with PR had a lower cost and was more effective, but compared with the LDV/SOF, in spite of its lower cost, it was less efficient. The QALY values obtained for PR, SOF + PR and LDV/SOF, respectively, were 10.98, 12.08 and 12.28 and their costs were $ 41,741, $ 7,676 and $ 46,993. Moreover, the results obtained from acceptability curves showed that SOF + PR were the most cost-effective treatment for thresholds below $ 45,270 PPP.
The use of SOF + PR regimen or LDV/SOF can significantly reduce the incidence of complications associated with the disease. For example, short and long-term outcomes are better than the current drug regimens for HCV genotype 1 patients in all stages of the disease.
尽管已为丙型肝炎病毒（HCV）患者引入了高效的新药物疗法，尤其是针对HCV基因1型患者，但伊朗尚未开展关于选择最佳药物策略的成本效益研究。
本研究旨在评估2014年伊朗HCV基因1型患者中聚乙二醇干扰素和利巴韦林（PR）、索磷布韦（SOF）+PR以及来迪派韦和索磷布韦（LDV/SOF）这三种药物疗法的成本效益。
采用马尔可夫微观模拟模型评估这三种药物策略对10000名患者队列的成本效益。从已发表的研究中提取质量调整生命年（QALY）。通过查阅病历并征求专家意见来估算成本数据。
结果显示，与PR相比，SOF+PR药物成本更低且更有效，但与LDV/SOF相比，尽管成本较低，效率却较低。PR、SOF+PR和LDV/SOF分别获得的QALY值为10.98、12.08和12.28，其成本分别为41741美元、7676美元和46993美元。此外，可接受性曲线的结果表明，对于低于45270国际元的阈值，SOF+PR是最具成本效益的治疗方法。
使用SOF+PR方案或LDV/SOF可显著降低与该疾病相关的并发症发生率。例如，在疾病的所有阶段，短期和长期结果均优于目前针对HCV基因1型患者的药物疗法。
