title: Cost-effectiveness of telaprevir in patients with genotype 1 hepatitis C in Australia.
abstract: BACKGROUND
  Protease inhibitors such as telaprevir (Incivo) are reimbursed in Australia for the treatment of patients with genotype 1 hepatitis C virus (HCV) infection in combination with pegylated interferon and ribavirin (PR).
  
  
  OBJECTIVE
  To assess the cost-effectiveness of telaprevir plus PR compared with PR alone in 1) previously untreated patients and 2) patients who had received treatment with PR earlier.
  
  
  METHODS
  Sustained virological response rates and average treatment durations of telaprevir and PR (given with or without telaprevir) were taken from the telaprevir ADVANCE and REALIZE clinical trials but were modified to take account of differences in prescribing rules between the trials and Australian clinical practice. The probability of transitioning between Markov disease states was based on data from the Australian Kirby Institute where possible and supplemented using data from the published literature. Utility values obtained from the EuroQol five-dimensional questionnaire data collected in the ADVANCE and REALIZE trials were used to represent the utility during HCV treatment. Utility values for Markov health states were taken from the published literature. Unit costs (2014 AU $) were taken from Australian sources.
  
  
  RESULTS
  In treatment-naive patients, the discounted cost per life-years gained was AU $37,706 and the discounted cost per quality-adjusted life-year was AU $19,283. In treatment-experienced patients, the discounted cost per life-year gained was AU $23,855 and the discounted cost per quality-adjusted life-year was AU $14,948.
  
  
  CONCLUSIONS
  Telaprevir plus PR in the Australian setting is cost-effective when compared with PR alone in patients infected with genotype 1 HCV.
authors.affiliation: HERA Consulting Australia Pty Ltd., Balmain, NSW, Australia. Electronic address: emma@heraconsulting.com.au.
authors.forename: Emma
authors.initials: E
authors.lastname: Warren
authors.affiliation: Janssen Australia Pty Ltd., North Ryde, NSW, Australia.
authors.forename: Alison
authors.initials: A
authors.lastname: Wright
authors.affiliation: Janssen Australia Pty Ltd., North Ryde, NSW, Australia.
authors.forename: Brandon
authors.initials: B
authors.lastname: Jones
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use*; D001315:Australia; D004359:Drug Therapy, Combination; D005838:Genotype; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000191:economics / Q000235:genetics*; D006801:Humans; D007372:Interferons / Q000008:administration & dosage / Q000191:economics; D008390:Markov Chains; D018803:Models, Economic; D009842:Oligopeptides / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use*; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000191:economics; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D016032:Randomized Controlled Trials as Topic; D012254:Ribavirin / Q000008:administration & dosage / Q000191:economics; D012720:Severity of Illness Index
chemical_list: D000998:Antiviral Agents; D009842:Oligopeptides; D011092:Polyethylene Glycols; D012254:Ribavirin; C486464:telaprevir; D007372:Interferons
keywords: Australia; Markov model; cost-effectiveness; economic modeling; hepatitis C