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Value in Hepatitis C Virus Treatment: A Patient-Centered Cost-Effectiveness Analysis

BACKGROUND: Innovations in hepatitis C virus (HCV) therapy included in traditional comparative evaluations focus on sustained virologic response (SVR) without addressing challenges patients report beyond virologic cure. This study aims to evaluate the cost-effectiveness of HCV drug therapy with a pa...

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Autores principales: Mattingly, T. Joseph, Slejko, Julia F., Onukwugha, Eberechukwu, Perfetto, Eleanor M., Kottilil, Shyamasundaran, Mullins, C. Daniel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081653/
https://www.ncbi.nlm.nih.gov/pubmed/31788751
http://dx.doi.org/10.1007/s40273-019-00864-8
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author Mattingly, T. Joseph
Slejko, Julia F.
Onukwugha, Eberechukwu
Perfetto, Eleanor M.
Kottilil, Shyamasundaran
Mullins, C. Daniel
author_facet Mattingly, T. Joseph
Slejko, Julia F.
Onukwugha, Eberechukwu
Perfetto, Eleanor M.
Kottilil, Shyamasundaran
Mullins, C. Daniel
author_sort Mattingly, T. Joseph
collection PubMed
description BACKGROUND: Innovations in hepatitis C virus (HCV) therapy included in traditional comparative evaluations focus on sustained virologic response (SVR) without addressing challenges patients report beyond virologic cure. This study aims to evaluate the cost-effectiveness of HCV drug therapy with a patient-centered approach. METHODS: An individual-based Markov model was constructed using guidance from a stakeholder advisory board (SAB), a patient Delphi panel, and published literature to evaluate direct-acting antivirals (DAAs) compared to no treatment. The United States (US) health sector and societal perspectives were considered for 10- and 20-year time horizons. Inputs for treatment costs and effectiveness reflect a generic regimen. Indirect costs used for the societal model included estimates from self-reported productivity in a matched-control sample. Beyond the traditional quality-adjusted life-year (QALY) health outcome, this study included two novel measures developed from the Delphi panel and SAB: infected life-years and workdays missed. All costs were measured in 2018 US dollars. RESULTS: Health sector costs and QALYs were higher in the treatment group in both 10- and 20-year models. Total infected life-years and workdays missed were reduced in the treatment group for both models. When costs of absenteeism, presenteeism, and patient/caregiver time were included, the DAA intervention was cost-saving at both 10 and 20 years. Health sector results were sensitive to drug costs and utility estimates for post-SVR health states. Societal results were sensitive to presenteeism estimates and drug costs. CONCLUSION: Treatment was cost-effective from a health sector perspective and cost-saving when including non-health costs such as patient/caregiver time and productivity. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40273-019-00864-8) contains supplementary material, which is available to authorized users.
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spelling pubmed-70816532020-03-23 Value in Hepatitis C Virus Treatment: A Patient-Centered Cost-Effectiveness Analysis Mattingly, T. Joseph Slejko, Julia F. Onukwugha, Eberechukwu Perfetto, Eleanor M. Kottilil, Shyamasundaran Mullins, C. Daniel Pharmacoeconomics Original Research Article BACKGROUND: Innovations in hepatitis C virus (HCV) therapy included in traditional comparative evaluations focus on sustained virologic response (SVR) without addressing challenges patients report beyond virologic cure. This study aims to evaluate the cost-effectiveness of HCV drug therapy with a patient-centered approach. METHODS: An individual-based Markov model was constructed using guidance from a stakeholder advisory board (SAB), a patient Delphi panel, and published literature to evaluate direct-acting antivirals (DAAs) compared to no treatment. The United States (US) health sector and societal perspectives were considered for 10- and 20-year time horizons. Inputs for treatment costs and effectiveness reflect a generic regimen. Indirect costs used for the societal model included estimates from self-reported productivity in a matched-control sample. Beyond the traditional quality-adjusted life-year (QALY) health outcome, this study included two novel measures developed from the Delphi panel and SAB: infected life-years and workdays missed. All costs were measured in 2018 US dollars. RESULTS: Health sector costs and QALYs were higher in the treatment group in both 10- and 20-year models. Total infected life-years and workdays missed were reduced in the treatment group for both models. When costs of absenteeism, presenteeism, and patient/caregiver time were included, the DAA intervention was cost-saving at both 10 and 20 years. Health sector results were sensitive to drug costs and utility estimates for post-SVR health states. Societal results were sensitive to presenteeism estimates and drug costs. CONCLUSION: Treatment was cost-effective from a health sector perspective and cost-saving when including non-health costs such as patient/caregiver time and productivity. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40273-019-00864-8) contains supplementary material, which is available to authorized users. Springer International Publishing 2019-12-02 2020 /pmc/articles/PMC7081653/ /pubmed/31788751 http://dx.doi.org/10.1007/s40273-019-00864-8 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Research Article
Mattingly, T. Joseph
Slejko, Julia F.
Onukwugha, Eberechukwu
Perfetto, Eleanor M.
Kottilil, Shyamasundaran
Mullins, C. Daniel
Value in Hepatitis C Virus Treatment: A Patient-Centered Cost-Effectiveness Analysis
title Value in Hepatitis C Virus Treatment: A Patient-Centered Cost-Effectiveness Analysis
title_full Value in Hepatitis C Virus Treatment: A Patient-Centered Cost-Effectiveness Analysis
title_fullStr Value in Hepatitis C Virus Treatment: A Patient-Centered Cost-Effectiveness Analysis
title_full_unstemmed Value in Hepatitis C Virus Treatment: A Patient-Centered Cost-Effectiveness Analysis
title_short Value in Hepatitis C Virus Treatment: A Patient-Centered Cost-Effectiveness Analysis
title_sort value in hepatitis c virus treatment: a patient-centered cost-effectiveness analysis
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081653/
https://www.ncbi.nlm.nih.gov/pubmed/31788751
http://dx.doi.org/10.1007/s40273-019-00864-8
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