title: Cost-effectiveness analysis of therapeutic options for chronic hepatitis C genotype 3 infected patients.
abstract: BACKGROUND
  This study provides a cost-effectiveness analysis of therapeutic strategies for chronic hepatitis C genotype 3 infected patients in Spain.
  
  
  METHODS
  A Markov model was designed to simulate the progression in a cohort of patients aged 50 years over a lifetime horizon.
  
  
  RESULTS
  Sofosbuvir (SOF) plus peginterferon and ribavirin for 12 weeks was a cost-effective option when compared to standard of care (SoC) in the treatment of both 'moderate fibrosis' and 'cirrhotic' patients. Incremental cost-effectiveness ratios were €35,276/QALY and €18,374/QALY respectively. ICERs for SOF plus daclatasvir (DCV) regimens versus SoC were over the threshold limit considered, at €56,178/QALY and €77,378/QALY for 'moderate fibrosis' and 'cirrhotic' patients respectively.
  
  
  CONCLUSIONS
  Addition of SOF to IFN-based regimens for genotype 3 was cost-effective for both 'moderate fibrosis' and 'cirrhotic' patients. IFN-free options including SOF and DCV association required price reductions lower than the list prices to be considered cost-effective.
authors: a Department of Pharmacy , Hospital Universitario Miguel Servet , Zaragoza , Spain.|b Faculty of Pharmacy , University of Granada , Granada , Spain.
authors: Vicente
authors: V
authors: Gimeno-Ballester
authors: c Clinical Management Service , Hospital Alto Deba , Mondragon , Spain.
authors: Javier
authors: J
authors: Mar
authors: d National Centre for Pharmacoeconomics , St James Hospital , Dublin , Ireland.
authors: Aisling
authors: A
authors: O'Leary
authors: d National Centre for Pharmacoeconomics , St James Hospital , Dublin , Ireland.
authors: Róisín
authors: R
authors: Adams
authors: b Faculty of Pharmacy , University of Granada , Granada , Spain.|d National Centre for Pharmacoeconomics , St James Hospital , Dublin , Ireland.|e Department of Pharmacy , Complejo Hospitalario de Navarra , Pamplona , Spain.
authors: Ramón
authors: R
authors: San Miguel
mesh_terms: D000998:Antiviral Agents / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D004359:Drug Therapy, Combination; D005838:Genotype; D016174:Hepacivirus / Q000187:drug effects* / Q000235:genetics / Q000472:pathogenicity; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics* / Q000821:virology; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics* / Q000821:virology; D008390:Markov Chains; D008875:Middle Aged; D018803:Models, Economic; D019057:Quality-Adjusted Life Years; D012720:Severity of Illness Index; D013030:Spain; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents
keywords: Direct acting antivirals; chronic hepatitis C; cost-effectiveness; daclatasvir; disease-related costs; pegylated interferon; protease inhibitors; ribavirin; sofosbuvir; treatment burden