Cost comparison of treating chronic hepatitis C genotype one with pegylated interferons in Ukraine

Olena Mandrik 1 , Saskia Knies 2 , Оlha Golubovska 3 , Oleksandr Duda 4 , Larisa Dudar 5 , Sergiy Fedorchenko 6 , Оlha Zaliska 7 , and J. L. (Hans) Severens 8
  • 1 Institute of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, the Netherlands
  • 2 Dutch Health Care Insurance Board, PO Box 320., 1110 AH Diemen, the Netherlands; Institute of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, the Netherlands
  • 3 O. Bogomolets National Medical University, Shevchenko av. 13., 01601 Kyiv, Ukraine
  • 4 P.L. Shupyk National Medical Academy of Postgraduate Education, Dorohozhyts’ka str. 9., 04112 Kyiv, Ukraine
  • 5 O. Bogomolets National Medical University, Shevchenko av. 13., 01601 Kyiv, Ukraine
  • 6 L. Gromashevskyi Institute of Epidemiology and Infectious Diseases, Amosova str. 5., 03038 Kyiv, Ukraine
  • 7 Danylo Halytsky Lviv National Medical University, Pekarska St. 69, 79010 Lviv, Ukraine
  • 8 Institute of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, the Netherlands, Institute of Medical Technology Assessment (iMTA), Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, the Netherlands

Abstract

Based on the pivotal trial showing no clinicallyrelevant differences between pegylated interferon α-2b (Peg-α-2b) and α-2a (Peg-α-2a) combined with ribavirin for treatment of chronic hepatitis C virus (HCV) genotype 1 infection in Ukraine, a cost-minimization analysis was performed using a 1 year time horizon and both a health care and patients’ perspective. A decision tree reflects treatment pathways. Drug costs were based on drug labeling and adjusted to the average body mass in Ukraine. Subgroup analysis was applied to deal with heterogeneity of patient’s weight causing dose changes. A break-even price of Peg-α-2a and Peg-α-2b (based on the average dose) was calculated. Univariate sensitivity analyses and probabilistic sensitivity analysis were carried out to reflect decision uncertainty. For an average body weight, total medical costs per patient differ from US$9220 for Peg-α-2b to US$9513 for Peg-α-2a from a health care perspective, and from US$15,212 to US$15,696 from a patients’ perspective. Sensitivity analyses show these results are robust. With average body weight, the break-even price of Peg-α-2b may be 7.3% higher than Peg-α-2a to have similar total costs.

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