Mohammad Alowairdhi1,2, Varun Vaidya3,4*, Eric Sahloff4 and Cindy Puffer5
1Department of Health Outcomes and Socioeconomic Sciences, University of Toledo,
Toledo, OH, USA
2Senior Pharmacist, Pricing and Pharmacoeconomics Department, Drug Sector, Saudi Food and Drug Authority, USA
3Division Head, Center for Pharmaceutical Care and Outcomes Research, College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, OH, USA
4Associate Professor, Department of Health Outcomes and Socioeconomic Sciences, University of Toledo, Toledo, OH, USA
5Managed Care Pharmacy Operations Manager, Department of Health Outcomes and Socioeconomic Sciences, University of Toledo, Toledo, OH, USA
*Corresponding Author: Varun Vaidya, Division Head, Center for Pharmaceutical Care and Outcomes Research, College of Pharmacy and Pharmaceutical Sciences and Associate Professor, Department of Health Outcomes and Socioeconomic Sciences, University of Toledo, Toledo, OH, USA.
Received: May 28, 2020; Published: August 26, 2020
Objectives: (1) To estimate the total costs of hepatitis C treatment choices recommended by the Saudi Association for the Study of Liver Diseases and Transplantation (SASLT) based on data from the Saudi Food and Drug Authority (SFDA), (2) To develop and operationalize the decision tree model and calculate the base case incremental cost-effectiveness ratio (ICER), (3) To perform one-way and probabilistic sensitivity analyses testing the underlying assumptions in the decision tree model.
Method: A cost-effectiveness analysis was performed on a hypothetical cohort comparing different chronic hepatitis C treatment strategies from the (SFDA)’s perspective over a three-month period using a decision tree model. Data for this study were obtained retrospectively from the (SFDA) and published literature. Costs were measured in United States Dollars (USD). Life-years gained (Ly) were the outcomes measured in this study. Since the SASLT guidelines differ between genotype 1 and genotype 4, There were two separate decision tree models and analyses for each genotype cohort at a willingness to pay (WTP) of $65,000.
Result and Discussion: In genotype 1 base case analysis, the incremental cost-effectiveness comparison between the interventions showed that both Elbasvir/Grazoprevir and Paritaprevir/Ritonavir/Ombitasvir plus Dasabuvir with Ribavirin (3D+RBV) dominated Sofosbuvir with Simeprevir and Ledipasvir/Sofosbuvir. Against 3D+RBV, the ICER was $33,796/Ly for each additional cure. In genotype 4 base case analysis, Paritaprevir/Ritonavir/Ombitasvir with Ribavirin (2D+RBV) dominated Ledipasvir/Sofosbuvir and Sofosbuvir plus Simeprevir. The interventions compared in genotype 1 are competitive and cost effective in exception of Sofosbuvir with Simeprevir while 2D+RBV is highly recommended in genotype 4. Interventions in both genotypes will be dominated by Sofosbuvir low-priced generics.
Keywords: Hepatitis C; Genotype 1; Genotype 4
Citation: Varun Vaidya., et al. “The Cost-Effectiveness of Treatments in Non-Cirrhotic Saudi Arabian Patients with Genotype 1 and Genotype 4 Chronic Hepatitis C".Acta Scientific Medical Sciences 4.9 (2020): 03-14.
Copyright: © 2020 Mayadhar Barik., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.