A new paradigm evaluating cost per cure of HCV infection in the UK
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Published version
Author(s)
Type
Journal Article
Abstract
Background: New interferon (IFN)-free treatments for hepatitis C are more effective, safer but more expensive than
current IFN-based therapies. Comparative data of these, versus current first generation protease inhibitors (PI) with
regard to costs and treatment outcomes are needed. We investigated the real-world effectiveness, safety and cost
per cure of 1st generation PI-based therapies in the UK.
Methods: Medical records review of patients within the HCV Research UK database. Patients had received
treatment with telaprevir or boceprevir and pegylated interferon and ribavirin (PR). Data on treatment outcome,
healthcare utilisation and adverse events (AEs) requiring intervention were collected and analysed overall and by
subgroups. Costs of visits, tests, therapies, adverse events and hospitalisations were estimated at the patient level.
Total cost per cure was calculated as total median cost divided by SVR rate.
Results: 154 patients from 35 centres were analysed. Overall median total cost per cure was £44,852 (subgroup
range,: £35,492 to £107,288). Total treatment costs were accounted for by PI: 68.3 %, PR: 26.3 %, AE management:
5.4 %. Overall SVR was 62.3 % (range 25 % to 86.2 %). 36 % of patients experienced treatment-related AEs requiring
intervention, 10 % required treatment-related hospitalisation.
Conclusions: This is the first UK multicentre study of outcomes and costs of PI-based HCV treatments in clinical
practice. There was substantial variation in total cost per cure among patient subgroups and high rates of
treatment-related discontinuations, AEs and hospitalisations. Real world safety, effectiveness and total cost per cure
for the new IFN free combinations should be compared against this baseline.
current IFN-based therapies. Comparative data of these, versus current first generation protease inhibitors (PI) with
regard to costs and treatment outcomes are needed. We investigated the real-world effectiveness, safety and cost
per cure of 1st generation PI-based therapies in the UK.
Methods: Medical records review of patients within the HCV Research UK database. Patients had received
treatment with telaprevir or boceprevir and pegylated interferon and ribavirin (PR). Data on treatment outcome,
healthcare utilisation and adverse events (AEs) requiring intervention were collected and analysed overall and by
subgroups. Costs of visits, tests, therapies, adverse events and hospitalisations were estimated at the patient level.
Total cost per cure was calculated as total median cost divided by SVR rate.
Results: 154 patients from 35 centres were analysed. Overall median total cost per cure was £44,852 (subgroup
range,: £35,492 to £107,288). Total treatment costs were accounted for by PI: 68.3 %, PR: 26.3 %, AE management:
5.4 %. Overall SVR was 62.3 % (range 25 % to 86.2 %). 36 % of patients experienced treatment-related AEs requiring
intervention, 10 % required treatment-related hospitalisation.
Conclusions: This is the first UK multicentre study of outcomes and costs of PI-based HCV treatments in clinical
practice. There was substantial variation in total cost per cure among patient subgroups and high rates of
treatment-related discontinuations, AEs and hospitalisations. Real world safety, effectiveness and total cost per cure
for the new IFN free combinations should be compared against this baseline.
Date Issued
2016-04-14
Date Acceptance
2016-03-16
Citation
Hepatology, Medicine and Policy, 2016, 1
ISSN
2059-5166
Publisher
BMC
Journal / Book Title
Hepatology, Medicine and Policy
Volume
1
Copyright Statement
© 2016 Barclay et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver
(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
License URL
Sponsor
Medical Research Council (MRC)
Medicins sans Frontiers (UK)
Grant Number
MR/K01532X/1
N/A
Publication Status
Published
Article Number
2
Date Publish Online
2016-04-14