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Incremental cost-effectiveness pharmacoeconomic assessment of hepatitis C virus therapy: an approach for less wealthy members of the common market (CROSBI ID 234763)

Prilog u časopisu | izvorni znanstveni rad | međunarodna recenzija

Mance, Diana ; Mance, Davor ; Vitezić, Dinko Incremental cost-effectiveness pharmacoeconomic assessment of hepatitis C virus therapy: an approach for less wealthy members of the common market // Croatian medical journal, 57 (2016), 6; 582-590. doi: 10.3325/cmj.2016.57.582

Podaci o odgovornosti

Mance, Diana ; Mance, Davor ; Vitezić, Dinko

engleski

Incremental cost-effectiveness pharmacoeconomic assessment of hepatitis C virus therapy: an approach for less wealthy members of the common market

Aim was to develop a new method of health-economic analysis based on a marginal approach. We tested the research hypothesis that a detailed comparative a priori incremental cost- effectiveness analysis provides the necessary input for budget impact analysis about the proper order of introduction of new therapies, and thus maximizes the cost-effectiveness bounded by the total budget constraint. For the analysis we chose a combination therapy for the treatment of hepatitis C virus (HCV) genotype 1 (GT1) infection, which was approved by the European Medicine Agency in 2015. We used the incremental cost-effective approach to assess the increase in the percentage of patients achieving sustained virological response (SVR) and the expenditure per additional SVR modulated by the new therapy’s market entrance dynamics. Patient subpopulations were differentiated by their response to previous treatment, presence of cirrhosis, and HCV GT1 subtype. Final parameters were estimated by Monte Carlo simulations. The new combination therapy had high efficacy, shorter duration, and was better tolerated than alternative interventions. The research hypothesis was confirmed: gradual introduction of the new therapy on the market, based on a priori incremental cost-effectiveness analysis, would result in average increase in successfully treated patients by 20%-40%, while additional costs would approximately be between 8%-40%, ie, €21 000-52 000 per additional patient achieving SVR. We showed the new combination therapy to be cost-effective for certain patient subpopulations, especially for experienced cirrhotic HCV GT1 patients. Results of the analysis are in agreement with the latest recommendations for HCV patients’ treatment in Croatia. This economic evaluation could serve as a starting point for negotiations between pharmaceutical industry and insurance companies.

pharmacoeconomics ; incremental cost-effectiveness analysis ; hepatitis C virus combination therapy

The work has been supported by the University of Rijeka, Croatia (project No. 836-10-1236). JEL Codes: H51, I18, L38.

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Podaci o izdanju

57 (6)

2016.

582-590

objavljeno

0353-9504

10.3325/cmj.2016.57.582

Povezanost rada

Fizika, Kliničke medicinske znanosti, Ekonomija

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