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HCV therapy found cost-effective in patients with severe liver disease

Treating hepatitis C virus infection and moderate to severe liver disease with antiviral therapy was cost-effective when beginning treatment immediately vs. delaying treatment, according to recently published data in Hepatology.

“This analysis investigates a common clinical situation, in which a clinician and patient must choose between starting treatment of HCV infection immediately or delaying treatment until later,” the researchers wrote.

Researchers developed a state-transition model to calculate costs and quality-adjusted life-years (QALYs) gained following HCV therapy in one patient aged 55 years with genotype 1 infection and moderate liver fibrosis (stage F2). Researchers also calculated incremental cost-effectiveness ratios (ICER) for HCV therapy at different stages of liver disease and compared them with delaying treatment until the subsequent liver disease stage, according to the research. The base case scenario of the patient was a treatment regimen that cost $100,000 and was 90% effective.

For this patient, the ICER  of beginning HCV treatment immediately at stage F2 compared with delaying treatment until stage F3 was $37,300 per QALY. If diagnosed earlier, the ICER increased to $174,000 per QALY for patients diagnosed and treated at stage F1 and $242,900 per QALY for patients diagnosed and treated at stage F0.

The threshold of therapy costs that yielded $50,000 per QALY and $100,000 per QALY cost-effectiveness ratios for patients with stage F0 treated immediately compared with delaying until F1 were $22,200 and $42,400, respectively.

“Treatment of HCV patients diagnosed with moderate to severe liver disease was found to be cost-effective,” the researchers concluded. “Earlier treatment can be a cost-effective use of resources in some scenarios and with certain thresholds of treatment costs. In the current era of evolving antiviral therapy for HCV infection, these results can help to inform policies that guide initiation of therapy.” – by Melinda Stevens

Disclosure: The researchers report no relevant financial disclosures.