title: [Cost-effectiveness analysis of sofosbuvir-simeprevir regimens for chronic hepatitis C genotype 1 patients with advanced fibrosis].
abstract: OBJECTIVE
  The aim of this study was to measure the cost-effectiveness of the treatment with simeprevir and sofosbuvir in chronic hepatitis C genotype 1 patients with F3-F4 levels of fibrosis, according to the results of the COSMOS trial.
  
  
  METHODS
  A Markov model was used to estimate the costs and clinical outcomes from the start of therapy. In the model, the progression was simulated alongside the different health states of the chronic liver disease associated with chronic hepatitis C using whole life as time-horizon.
  
  
  RESULTS
  The 12-weeks treatment schemes was below the threshold of €40,000 per quality-adjusted life year. On the contrary, despite the 50% cost reduction, the 24-weeks regimen demonstrated a limited level of efficiency when compared with the willingness to pay used in the Spanish medical literature.
  
  
  CONCLUSIONS
  This finding would support the introduction of a flat rate in the price of drugs without taking into account the duration of treatment to ensure that treatment with 24 weeks was efficient.
authors.affiliation: Unidad de Gestión Sanitaria, Hospital Alto Deba, Mondragón, Guipúzcoa, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, España. Electronic address: javier.marmedina@osakidetza.net.
authors.forename: Javier
authors.initials: J
authors.lastname: Mar
authors.affiliation: Facultad de Medicina, Universidad de Barcelona, Barcelona, España.
authors.forename: Lorea
authors.initials: L
authors.lastname: Mar-Barrutia
authors.affiliation: Servicio de Farmacia, Hospital Universitario Miguel Servet, Zaragoza, España; Facultad de Farmacia, Universidad de Granada, Granada, España.
authors.forename: Vicente
authors.initials: V
authors.lastname: Gimeno-Ballester
authors.affiliation: Facultad de Farmacia, Universidad de Granada, Granada, España; Servicio de Farmacia, Complejo Hospitalario de Navarra, Pamplona, Navarra, España.
authors.forename: Ramón
authors.initials: R
authors.lastname: San Miguel
mesh_terms: D000998:Antiviral Agents / Q000191:economics / Q000627:therapeutic use*; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D018450:Disease Progression; D016527:Drug Costs; D004359:Drug Therapy, Combination; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000191:economics / Q000821:virology; D006801:Humans; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000191:economics / Q000209:etiology / Q000601:surgery; D016031:Liver Transplantation / Q000191:economics; D008390:Markov Chains; D019057:Quality-Adjusted Life Years; D000069616:Simeprevir / Q000191:economics / Q000627:therapeutic use*; D000069474:Sofosbuvir / Q000191:economics / Q000627:therapeutic use*; D013030:Spain
chemical_list: D000998:Antiviral Agents; D000069616:Simeprevir; D000069474:Sofosbuvir
keywords: Cost-effectiveness; Coste-efectividad; Hepatitis C; Simeprevir; Sofosbuvir