泽必泰用于意大利 HCV 管理的经济学评价。
Economic evaluation of Zepatier for the management of HCV in the Italian scenario.
机构信息
Catholic University of Sacred Heart, Largo Francesco Vito 1, 00186, Rome, Italy.
Istituto di Sanità Pubblica, Sezione Igiene, Catholic University of Sacred Heart, Rome, Italy.
出版信息
Eur J Health Econ. 2018 Dec;19(9):1365-1374. doi: 10.1007/s10198-018-0980-4. Epub 2018 Apr 25.
BACKGROUND
Hepatitis C virus (HCV) is a major health issue worldwide. New generation of direct-active antiviral medications is an epoch-making turning point in the management of HCV infections.
OBJECTIVE
Conducing a cost-effectiveness analysis comparing the combination of elbasvir/grazoprevir and sofosbuvir + pegylated interferon/ribavirin for the management of all HCV patients (even those in the initial stages of fibrosis).
METHODS
A Markov model was built on the natural history of the disease to assess the efficacy of the alternatives. The outcomes are expressed in terms of quality adjusted life-years (QALYs) and result in terms of incremental cost-effectiveness ratio).
RESULTS
Elbasvir/grazoprevir implies an expenditure of €21,104,253.74 with a gain of 19,287.90 QALYs and sofosbuvir + pegylated interferon/ribavirin implies an expenditure of €31,904,410.11 with a gain of 18,855.96 QALYs. Elbasvir/grazoprevir is thus a dominant strategy.
CONCLUSION
Consideration should be given to the opportunity cost of not treating patients with a lower degree of fibrosis (F0-F2).
背景
丙型肝炎病毒（HCV）是全球范围内的一个主要健康问题。新一代直接作用抗病毒药物是 HCV 感染治疗的一个划时代的转折点。
目的
对 elbasvir/grazoprevir 联合 sofosbuvir + 聚乙二醇干扰素/利巴韦林治疗所有 HCV 患者（甚至纤维化早期患者）进行成本效益分析。
方法
建立一个疾病自然史的 Markov 模型来评估替代方案的疗效。结果以质量调整生命年（QALYs）表示，并以增量成本效益比（ICER）表示。
结果
elbasvir/grazoprevir 的支出为 21104253.74 欧元，获得 19287.90 个 QALYs；sofosbuvir + 聚乙二醇干扰素/利巴韦林的支出为 31904410.11 欧元，获得 18855.96 个 QALYs。因此，elbasvir/grazoprevir 是一种优势策略。
结论
应考虑不治疗纤维化程度较低（F0-F2）患者的机会成本。
Zotero 插件