title: The cost-effectiveness of daclatasvir-based regimens for the treatment of hepatitis C virus genotypes 1 and 4 in the UK.
abstract: OBJECTIVE
  This study aimed to determine the cost-effectiveness of daclatasvir in combination with other medicinal products for the treatment of patients with hepatitis C virus genotypes 1 and 4 and advanced liver disease in the UK.
  
  
  METHODS
  A published and validated Markov model designed to simulate the natural history of chronic hepatitis C was used to compare daclatasvir with relevant treatment options for patients with hepatitis C virus genotypes 1 and 4 and a METAVIR score of F3-F4. Patients were defined according to their treatment status; that is, naive, experienced or interferon ineligible/intolerant. Data inputs for the analysis were derived from published sources, UK-specific where possible. A lifetime horizon was used, with costs and benefits discounted at 3.5%.
  
  
  RESULTS
  Daclatasvir-based regimens are estimated to be cost-effective versus no treatment and established standard-of-care regimens, including telaprevir in combination with pegylated interferon-α+ribavirin (PR), boceprevir in combination with PR and PR alone (incremental cost-effectiveness ratio range: £3715-£15,408). The cost-effectiveness of daclatasvir-based regimens versus emerging regimens (sofosbuvir or simeprevir based) is less consistent, but was dominant or cost-effective (incremental cost-effectiveness ratio range: £1394-£28,393) in all except two scenarios.
  
  
  CONCLUSIONS
  Daclatasvir-based regimens are expected to be highly cost-effective for the majority patients with advanced disease versus relevant comparator regimens, including newer direct-acting antiviral regimens.
authors.affiliation: aHEOR, HEOR Ltd, Monmouth bUK HEOR, Bristol-Myers Squibb Pharmaceuticals Ltd, Uxbridge cSwansea Centre for Health Economics, School of Human & Health Sciences, Swansea University, Swansea, UK dDepartment of Public Health, University of Adelaide, Adelaide, South Australia, Australia eWorld Wide Health Economics and Outcomes Research, Bristol-Myers Squibb Pharmaceuticals Ltd, Princeton, New Jersey, USA.
authors.forename: Phil
authors.initials: P
authors.lastname: McEwan
authors.forename: Hayley
authors.initials: H
authors.lastname: Bennett
authors.forename: Thomas
authors.initials: T
authors.lastname: Ward
authors.forename: Samantha
authors.initials: S
authors.lastname: Webster
authors.forename: Jason
authors.initials: J
authors.lastname: Gordon
authors.forename: Anupama
authors.initials: A
authors.lastname: Kalsekar
authors.forename: Yong
authors.initials: Y
authors.lastname: Yuan
authors.forename: Michael
authors.initials: M
authors.lastname: Brenner
mesh_terms: D000998:Antiviral Agents / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D002219:Carbamates; D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D005838:Genotype; D016174:Hepacivirus / Q000187:drug effects* / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D008390:Markov Chains; D018803:Models, Economic; D010641:Phenotype; D011480:Protease Inhibitors / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D011759:Pyrrolidines; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology; D014633:Valine / Q000031:analogs & derivatives
chemical_list: D000998:Antiviral Agents; D002219:Carbamates; D007093:Imidazoles; D011480:Protease Inhibitors; D011759:Pyrrolidines; D014633:Valine; C549273:daclatasvir