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• W2912587891 abstract "The prohibitively high cost of direct-acting antivirals (DAA) for hepatitis C virus (HCV) infection remains a barrier to treatment access in Singapore. We aimed to evaluate whether DAA as first-line therapy would be cost-effective for genotype 3 (GT3) HCV patients compared with pegylated interferon and ribavirin (PR).A decision tree analysis was used to compare the costs and outcomes of DAA and PR as first-line therapy. Treatment effectiveness, defined as sustained virological response, was assessed using a retrospective cohort of treated GT3 HCV patients. Direct medical costs were estimated from the payer's perspective using billing information. We obtained health utilities from published literature. We performed extensive one-way sensitivity analyses and probabilistic sensitivity analyses to account for uncertainties regarding the model parameters.In base case analysis, first-line therapy with DAA and PR yielded quality-adjusted life years (QALYs) of 0.69 and 0.62 at a cost of USD 54 634 and USD 23 857, respectively. The resultant incremental cost-effectiveness ratio (ICER) (USD 449 232/QALY) exceeded the willingness-to-pay threshold (USD 53 302/QALY). The ICER was robust for uncertainties regarding the model parameters. The cost of DAA is the key factor influencing the cost-effectiveness of HCV treatment. At current price, DAA as first-line therapy is not cost-effective compared with PR, with or without consideration of retreatment. Threshold analysis suggested that DAA can be cost-effective if it costs less than USD 17 002 for a 12-week treatment course.At current price, DAA as first-line therapy is not cost-effective compared with PR in GT3 HCV patients in Singapore." @default.
• W2912587891 created "2019-02-21" @default.
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• W2912587891 date "2019-02-08" @default.
• W2912587891 modified "2023-10-13" @default.
• W2912587891 title "Economic evaluation of direct‐acting antivirals for the treatment of genotype 3 hepatitis C infection in Singapore" @default.
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• W2912587891 doi "https://doi.org/10.1002/jgh3.12139" @default.
• W2912587891 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/6586564" @default.
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• W2912587891 hasPublicationYear "2019" @default.
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