title: Impact of hepatitis C triple therapy availability upon the number of patients to be treated and associated costs in France: a model-based analysis.
abstract: OBJECTIVE
  The combination of pegylated interferon (PEG-IFN), ribavirin (RBV) and a protease inhibitor (PI) has been approved in summer 2011 for the treatment of genotype 1 (G1) hepatitis C virus (HCV)-infected patients, with a substantially improved efficacy. The aim of this study was to estimate the number of G1 patients to be treated in France in 2012 and associated costs.
  
  
  METHODS
  A published model of HCV and data on PEG-IFN sales were used to estimate patients needing treatment using three scenarios. (1) HCV screening rate unchanged versus 2010; proportion of treated F0-F1 patients unchanged, proportion of treated F2-F4 patients increased to the current proportion of treated F2-F4 G2/3 patients. (2) Scenario 1 but the proportion of treated F0-F1 patients increased to the current proportion of treated F0-F1 G2/3 patients. (3) Scenario 2 but a 5% increase in the HCV screening rate. To estimate cost, treatment duration was multiplied by drug unit cost. Probabilities corresponding to treatment duration were estimated based on liver fibrosis stage, treatment-naive or experienced status of the patient and virological response kinetics on treatment.
  
  
  RESULTS
  Compared with the 5100 G1 patients treated in 2010, the number of G1 patients receiving treatment in 2012 would be 15,000 in scenario 1, 18,300 in scenario 2 and 19,400 in scenario 3, among whom 2.5-3.7% may receive PEG-IFN/RBV and 96.3-97.5% PEG-IFN/RBV+PI. Costs associated with this regimen use ranged from 497 to 638 million Euros.
  
  
  CONCLUSIONS
  These model-based estimates indicate that new anti-HCV treatments may result in a three- to fourfold increase in the number of G1 patients to be treated in France in 2012.
authors.affiliation: ATIP-AVENIR Inserm U995, Université Lille Nord de France, Lille, France. sylvie.burban@neuf.fr
authors.forename: Sylvie
authors.initials: S
authors.lastname: Deuffic-Burban
authors.forename: Philippe
authors.initials: P
authors.lastname: Mathurin
authors.forename: Stanislas
authors.initials: S
authors.lastname: Pol
authors.forename: Christine
authors.initials: C
authors.lastname: Larsen
authors.forename: Françoise
authors.initials: F
authors.lastname: Roudot-Thoraval
authors.forename: Jean Claude
authors.initials: JC
authors.lastname: Desenclos
authors.forename: Daniel
authors.initials: D
authors.lastname: Dhumeaux
authors.forename: Yazdan
authors.initials: Y
authors.lastname: Yazdanpanah
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000191:economics / Q000627:therapeutic use*; D003198:Computer Simulation; D018450:Disease Progression; D016527:Drug Costs; D004359:Drug Therapy, Combination; D004363:Drug Utilization / Q000191:economics / Q000706:statistics & numerical data*; D005602:France; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000191:economics; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000191:economics / Q000627:therapeutic use*; D008390:Markov Chains; D008875:Middle Aged; D018803:Models, Economic; D011092:Polyethylene Glycols / Q000191:economics / Q000627:therapeutic use*; D011480:Protease Inhibitors / Q000191:economics / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000191:economics / Q000627:therapeutic use; D012254:Ribavirin / Q000191:economics / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011480:Protease Inhibitors; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b