The European Journal of Health Economics

, Volume 19, Issue 9, pp 1365–1374 | Cite as

Economic evaluation of Zepatier for the management of HCV in the Italian scenario

  • F. R. Rolli
  • M. Ruggeri
  • F. Kheiraoui
  • C. Drago
  • M. Basile
  • C. Favaretti
  • A. Cicchetti
Original Paper



Hepatitis C virus (HCV) is a major health issue worldwide. New generation of direct-active antiviral medications is an epoch-making turning point in the management of HCV infections.


Conducing a cost-effectiveness analysis comparing the combination of elbasvir/grazoprevir and sofosbuvir + pegylated interferon/ribavirin for the management of all HCV patients (even those in the initial stages of fibrosis).


A Markov model was built on the natural history of the disease to assess the efficacy of the alternatives. The outcomes are expressed in terms of quality adjusted life-years (QALYs) and result in terms of incremental cost-effectiveness ratio).


Elbasvir/grazoprevir implies an expenditure of €21,104,253.74 with a gain of 19,287.90 QALYs and sofosbuvir + pegylated interferon/ribavirin implies an expenditure of €31,904,410.11 with a gain of 18,855.96 QALYs. Elbasvir/grazoprevir is thus a dominant strategy.


Consideration should be given to the opportunity cost of not treating patients with a lower degree of fibrosis (F0–F2).


Cost-effectiveness analysis ICER Sensitivity analysis Opportunity cost HCV 

JEL Classification

H51 Government expenditure and Health 


Author contributions

All authors made a substantial contribution to the conception, design, acquisition of data and related analysis and interpretation and participated in drafting the article and revising it critically and according to its important intellectual content.


The analysis was developed with the unconditioned support of MSD Italia S.r.l.. The views expressed here are those of the authors and not necessarily those of the funders.

Compliance with ethical standards

Conflict of interest

None of the authors (Drs. Rolli, Dr. Ruggeri, Drs. Kheiraoui, Dr. Drago, Dr. Basile, Drs. Favaretti, Dr. Cicchetti) has any potential conflict of interest related to this manuscript.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • F. R. Rolli
    • 1
  • M. Ruggeri
    • 1
  • F. Kheiraoui
    • 3
    • 4
  • C. Drago
    • 2
  • M. Basile
    • 1
  • C. Favaretti
    • 4
  • A. Cicchetti
    • 1
  1. 1.Catholic University of Sacred HeartRomeItaly
  2. 2.“Nicolò Cusano” UniversityRomeItaly
  3. 3.Istituto di Sanità Pubblica, Sezione IgieneCatholic University of Sacred HeartRomeItaly
  4. 4.VIHTALI, Value in Health Technology and Academy for Leadership and Innovation Spin-Off of the Catholic University of Sacred HeartRomeItaly

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