Applied Health Economics and Health Policy

, Volume 12, Issue 6, pp 647–659

Cost Utility of Telaprevir–PR (Peginterferon–Ribavirin) Versus Boceprevir–PR and Versus PR Alone in Chronic Hepatitis C in The Netherlands

  • Aikaterini Vellopoulou
  • Michel van Agthoven
  • Annemarie van der Kolk
  • Robert J. de Knegt
  • Gilles Berdeaux
  • Sandrine Cure
  • Florence Bianic
  • Mark Lamotte
Original Research Article

DOI: 10.1007/s40258-014-0120-y

Cite this article as:
Vellopoulou, A., van Agthoven, M., van der Kolk, A. et al. Appl Health Econ Health Policy (2014) 12: 647. doi:10.1007/s40258-014-0120-y

Abstract

Background

The hepatitis C virus may lead to cirrhosis, liver cancer, liver transplant, and increased mortality. With standard treatment peginterferon-alpha and ribavirin (PR), sustained viral response (SVR) was less than 50 %. SVR rates improve greatly when PR is combined with telaprevir or boceprevir.

Objectives

The aim of this study was to assess the cost utility of telaprevir-peginterferon-ribavirin (TPR) versus PR and boceprevir-peginterferon-ribavirin (BPR) in treatment-naïve (TN) and treatment-experienced (TE) adults with chronic hepatitis C in the Netherlands.

Methods

A Markov model with a lifelong time horizon and annual cycles was developed. Clinical data stemmed from phase III trials (TPR vs PR, BPR vs PR). A mixed treatment comparison (MTC) was developed to compare TPR and BPR indirectly. Unit costs and utilities based on EQ-5D were established in a Dutch cross-sectional study. Cost per quality-adjusted life-years (QALYs) was calculated according to the societal perspective.

Results

Treating TN patients with TPR generates 1.12 additional QALYs with €333 additional cost compared with PR, resulting in an incremental cost–utility ratio of €299/QALY. In TE patients, TPR dominates PR with cost savings (−€7,819) and 1.63 additional QALYs. TPR dominates BPR yielding additional QALYs (0.26 in TN; 0.71 in TE) and cost savings (−€7,296, −€18,144, respectively).

Conclusions

TPR seems a cost-effective alternative to PR in TN patients and dominant in TE patients. TPR was a dominant, more effective and less costly alternative to BPR in both patient types. The cost effectiveness of both TPR and BPR is well below generally accepted willingness-to-pay thresholds and may be considered cost effective.

Supplementary material

40258_2014_120_MOESM1_ESM.docx (72 kb)
Supplementary material 1 (DOCX 72 kb)

Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Aikaterini Vellopoulou
    • 1
  • Michel van Agthoven
    • 2
  • Annemarie van der Kolk
    • 2
  • Robert J. de Knegt
    • 3
  • Gilles Berdeaux
    • 1
    • 4
  • Sandrine Cure
    • 5
  • Florence Bianic
    • 6
  • Mark Lamotte
    • 1
  1. 1.Health Economics and Outcome Research DepartmentIMS HealthVilvoordeBelgium
  2. 2.Janssen-Cilag B.V.TilburgThe Netherlands
  3. 3.Department of Gastroenterology and HepatologyErasmus MC University Medical CenterRotterdamThe Netherlands
  4. 4.Département Droit, Intervention Sociale, Santé, TravailConservatoire National des Arts et MétiersParisFrance
  5. 5.OptimumInsightUxbridgeUK
  6. 6.OptimumInsightNanterreFrance

Personalised recommendations