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Inicio Medicina Clínica (English Edition) Cost-effectiveness analysis of sofosbuvir-simeprevir regimens for chronic hepati...
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Vol. 146. Issue 2.
Pages 61-64 (January 2016)
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Vol. 146. Issue 2.
Pages 61-64 (January 2016)
Brief report
Cost-effectiveness analysis of sofosbuvir-simeprevir regimens for chronic hepatitis C genotype 1 patients with advanced fibrosis
Análisis coste-efectividad del tratamiento de la hepatitis C crónica con sofosbuvir-simeprevir en pacientes con genotipo 1 y fibrosis avanzada
Javier Mara,b,
Corresponding author
javier.marmedina@osakidetza.net

Corresponding author.
, Lorea Mar-Barrutiac, Vicente Gimeno-Ballesterd,e, Ramón San Miguele,f
a Unidad de Gestión Sanitaria, Hospital Alto Deba, Mondragón, Guipúzcoa, Spain
b Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Spain
c Facultad de Medicina, Universidad de Barcelona, Barcelona, Spain
d Servicio de Farmacia, Hospital Universitario Miguel Servet, Zaragoza, Spain
e Facultad de Farmacia, Universidad de Granada, Granada, Spain
f Servicio de Farmacia, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
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Table 1. Results and sensitivity analysis of cost-effectiveness analysis in accordance with the alternative to Cosmos clinical trial and drug prices.
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Abstract
Background and objective

The aim of this study was to measure the cost-effectiveness of the treatment with simeprevir and sofosbuvir in chronic hepatitis C genotype 1 patients with F3-F4 levels of fibrosis, according to the results of the COSMOS trial.

Material and methods

A Markov model was used to estimate the costs and clinical outcomes from the start of therapy. In the model, the progression was simulated alongside the different health states of the chronic liver disease associated with chronic hepatitis C using whole life as time-horizon.

Results

The 12-weeks treatment schemes was below the threshold of €40,000 per quality-adjusted life year. On the contrary, despite the 50% cost reduction, the 24-weeks regimen demonstrated a limited level of efficiency when compared with the willingness to pay used in the Spanish medical literature.

Conclusions

This finding would support the introduction of a flat rate in the price of drugs without taking into account the duration of treatment to ensure that treatment with 24 weeks was efficient.

Keywords:
Hepatitis C
Sofosbuvir
Simeprevir
Cost-effectiveness
Resumen
Introducción y objetivo

El objetivo de este estudio fue medir la relación coste-efectividad del tratamiento con simeprevir y sofosbuvir en pacientes con hepatitis C crónica genotipo 1 y grados de fibrosis F3-F4, de acuerdo con los resultados del ensayo clínico COSMOS.

Material y métodos

Se utilizó un modelo de Markov para estimar los costes y los resultados clínicos desde el comienzo del tratamiento. Usando como horizonte temporal toda la vida del paciente, en el modelo se simuló la progresión de la enfermedad entre los diferentes estados de salud de la enfermedad hepática crónica asociada a la hepatitis C.

Resultados

Los regímenes de 12 semanas se situaron por debajo del umbral de 40.000€/año de vida ajustado por calidad. Por el contrario, aun con una reducción del 50% del coste de adquisición, el régimen de 24 semanas demostró un nivel de eficiencia en el límite del requerido por la disponibilidad a pagar utilizada en la literatura médica española.

Conclusiones

Este último dato justificaría la introducción de un coste igual para la duración de 12 y 24 semanas, asegurando la eficiencia del tratamiento de duración prolongada.

Palabras clave:
Hepatitis C
Sofosbuvir
Simeprevir
Coste-efectividad

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