title: Personalized cost-effectiveness of boceprevir-based triple therapy for untreated patients with genotype 1 chronic hepatitis C.
abstract: BACKGROUND
  We assessed the cost-effectiveness of boceprevir-based triple therapy compared to peginterferon alpha and ribavirin dual therapy in untreated patients with genotype 1 chronic hepatitis C; patients were discriminated according to the combination of baseline plus on-treatment predictors of boceprevir-based triple therapy.
  
  
  METHODS
  Cost-effectiveness analysis performed according to data from the available published literature. The target population was composed of untreated Caucasian patients, aged 50 years, with genotype 1 chronic hepatitis C, and these were evaluated over a lifetime horizon by Markov model. The study was carried out from the perspective of the Italian National Health Service. Outcomes included discounted costs (in euro, at 2013 value), life-years gained, quality-adjusted life year, and incremental cost-effectiveness ratio. The robustness of the results was evaluated by multivariable probabilistic sensitivity analyses.
  
  
  RESULTS
  According to the baseline predictors of sustained virological response (genotype 1b, low viral load, fibrosis F0-F3, and body mass index) and the 1Log drop of HCV-RNA after the dual therapy lead-in period, boceprevir was cost-effective in different patient profiles.
  
  
  CONCLUSIONS
  In untreated genotype 1b chronic hepatitis C patients, the cost-effectiveness of boceprevir-based triple therapy widely ranges according to different profiles of sustained virological response predictors, allowing optimization and personalization of triple therapy.
authors: Section of Gastroenterology, Di.Bi.M.I.S., University of Palermo, Italy.
authors: Salvatore
authors: S
authors: Petta
authors: Section of Gastroenterology, Di.Bi.M.I.S., University of Palermo, Italy.
authors: Giuseppe
authors: G
authors: Cabibbo
authors: Department of Economic, Business and Statistic Science (SEAS), University of Palermo, Palermo, Italy.
authors: Marco
authors: M
authors: Enea
authors: Section of Gastroenterology, Di.Bi.M.I.S., University of Palermo, Italy.
authors: Fabio Salvatore
authors: FS
authors: Macaluso
authors: Department of Economic, Business and Statistic Science (SEAS), University of Palermo, Palermo, Italy.
authors: Antonella
authors: A
authors: Plaia
authors: Division of Infectious and Tropical Diseases, Foundation IRCCS San Matteo Hospital, University of Pavia, Italy.
authors: Raffaele
authors: R
authors: Bruno
authors: Gastroenterology Unit, Catholic University, Rome, Italy.
authors: Antonio
authors: A
authors: Gasbarrini
authors: Department of Internal Medicine, A.O. Fatebenefratelli e Oftalmico, Milan, Italy.
authors: Savino
authors: S
authors: Bruno
authors: Section of Gastroenterology, Di.Bi.M.I.S., University of Palermo, Italy.
authors: Antonio
authors: A
authors: Craxì
authors: Section of Gastroenterology, Di.Bi.M.I.S., University of Palermo, Italy. Electronic address: calogero.camma@unipa.it.
authors: Calogero
authors: C
authors: Cammà
mesh_terms: D000998:Antiviral Agents / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000191:economics / Q000821:virology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000191:economics / Q000627:therapeutic use*; D007558:Italy; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D018803:Models, Economic; D015999:Multivariate Analysis; D009313:National Health Programs / Q000191:economics; D011092:Polyethylene Glycols / Q000191:economics / Q000627:therapeutic use*; D011392:Proline / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D011994:Recombinant Proteins / Q000191:economics / Q000627:therapeutic use; D012254:Ribavirin / Q000191:economics / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C512204:N-(3-amino-1-(cyclobutylmethyl)-2,3-dioxopropyl)-3-(2-((((1,1-dimethylethyl)amino)carbonyl)amino)-3,3-dimethyl-1-oxobutyl)-6,6-dimethyl-3-azabicyclo(3.1.0)hexan-2-carboxamide; D011392:Proline; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a
keywords: Boceprevir; Cost-effectiveness; Peg-interferon