Cost-effectiveness of Sofosbuvir for the treatment of chronic hepatitis C-infected patients

This study analyzes the cost-effectiveness of Sofosbuvir as a treatment option for chronic hepatitis C-infected patients. It compares the costs and consequences of Sofosbuvir with other treatment options, such as ribavirin and pcgylatcd interferon, and evaluates their effectiveness in yielding desirable patient care outcomes. The study also measures costs and consequences accurately through Incremental Cost-Effectiveness Ratio (ICER) per QALY and ICER per Life Years. The findings suggest that Sofosbuvir is the most cost-effective option with improvements in health outcomes.

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Health Economics
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1. A well-defined question posed in an answerable form is “How much does each
available treatment option for Chronic Hepatitis C cost in terms of money to the patients?”
(Cure, Guerra & Dusheiko 2015 p. 882)
2. A comprehensive description of the competing alternatives was given in form of
identifying treatment options for Chronic Hepatitis C. They included; Sofosbuvir, ribavirin and
pcgylatcd interferon which are the competing treatment options for patients. Among the above
competing alternatives, Sofosbuvir has proved to be the best option for the patients due to the
fact that it has sustained over 90% of virological responses across treatment naive genotypes 1 to
6. On the other hand, the other treatment options that is to say ribavirin and pcgylatcd interferon
as first-generation protease inhibitors are only limited to treatment of only genotype 1 Hepatitis
C infections. (Cure, Guerra & Dusheiko 2015 p. 883)
3. Effectiveness of the programmes was established given that Sofosbuvir, ribavirin and
pcgylatcd interferon have been effective in yielding desirable patient care outcomes in regards to
control of Chronic Hepatitis C in United Kingdom. Most significantly, all the above treatment
programmes are covering all the genotypes from 1 to 6 for Chronic Hepatitis C infections which
have ensured that genotype differences do not have an impact care outcomes (Cure, Guerra &
Dusheiko 2015 p. 883)
4. All the important and relevant costs and consequences for each alternative were
identified whereby a threshold of £20 000/Quality Adjusted Life Years (QALY) was set. Among
all treatment options, Sofosbuvir was the best cost effective option with £11 836/ QALY. As
such, Sofosbuvir resulted into improvements in health outcomes. Pcgylatcd interferon Genotype

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1 patients involves a cost of £49 249/QALY and ribavirin would cost about £30 000/QALY.
Both Pcgylatcd interferon and ribavirin improved long-term complications across genotype 1
chronic hepatitis C infections (Cure, Guerra & Dusheiko 2015 p. 884)
5. Additionally, costs and consequences were measured accurately in appropriate
physical units in form of Incremental Cost-Effectiveness Ratio (ICER) per QALY and ICER per
Life Years. These costs and consequences were measured from the outcomes of Markov model
schematic for chronic hepatitis C. In the due course of measuring costs, the number of cases of
compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma and life years were
avoided. Also, consequences were measured through gauging of ICER against the life years and
quality adjusted life years for all the treatment alternatives (Cure, Guerra & Dusheiko 2015 p.
884)
6. In addition, costs and consequences were valued credibly due to that fact that
specification was made on the currency, number of weeks for assessment of treatments as well as
the combinations of treatment options. Use of the pound sterling (£) currency makes it credible
for the costs and consequences are credible due to specification of weeks like 12 and 48 weeks
that were considered for making assessment on combination of treatment options (Cure, Guerra
& Dusheiko 2015 p. 885)
7. Furthermore, costs and consequences were adjusted for differential timing by
calculating the differences in lives, compensated cirrhosis, decompensated cirrhosis, and
hepatocellular carcinoma and life years. In the due process of calculating the differential timings
for costs and consequences, weeks of administration of combination of treatment options were

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also considered. As a result, negative and positive figures were exhibited after differential timing
had been adjusted for costs and consequences (Cure, Guerra & Dusheiko 2015 p. 885).
8. Also, incremental analysis of costs and consequences of alternatives was performed
through incremental cost effective ratio. The above ratio was derived from the outcomes of
Markov model schematic for chronic hepatitis C which was executed per life times and quality
adjusted life time for various combinations of treatment option over different weeks (Cure,
Guerra & Dusheiko 2015 p. 886)
9. Allowance was made for uncertainty in the estimates of costs and consequences by
discounting them at 3.5%. All costs and consequences were utilized with prior consideration for
all the costs that were applicable to National Health Service of United Kingdom (Cure, Guerra &
Dusheiko 2015 p. 882)
10. Presentation and discussion of study was well structured and comprehensive
respectively for the reader to effectively comprehend. Treatment options for hepatitis C virus that
are based on PI indicated improvements to Sustained Virological Response (SVR) rates for
patients with genotype 1.Despite the improvements on SVR rates, there exists a need to make
use of better pan genotypic treatment option for treatment naive and treatment experienced with
compensated cirrhosis or decompensated cirrhosis. Findings from the results indicated that SVR
rates for hepatitis C virus and human immune virus for population that are co infected are the
same across all genotypes (Cure, Guerra & Dusheiko 2015 p. 887)

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Reference
Cure, S, Guerra, I & Dusheiko, G., 2015. Cost-effectiveness of Sofosbuvir for the treatment of
chronic hepatitis C-infected patients: Journal of Viral Hepatitis, 2015, 22, 882–889