OBJECTIVES: To perform a systematic literature review of economic evidence for genotype 1 hepatitis C virus (HCV) treatments.
METHODS: Searches were performed in MEDLINE, MEDLINE In-Process, EconLit, Embase, BIOSIS, and the Cochrane Library, to identify economic evaluations, cost/resource studies, and utility studies in patients with genotype 1 HCV. Searches were limited to articles published since 2000. Additional searches were performed on the ISPOR conference and key Health Technology Assessment (HTA) websites.
RESULTS: The review identified 53 economic evaluations, 17 HTA documents, 57 cost/resource use studies, and 19 utility studies. The majority of economic evaluations were in interferon-containing regimens and were performed using lifetime horizon Markov models. Incremental cost-effectiveness ratios ranged from $4,570.31 to $157,404.13, depending on patient severity, the treatment used and the duration of treatment. Boceprevir and telaprevir triple therapies were shown to be cost-effective compared with peginterferon and ribavirin alone. In the cost studies, total all-cause, annual costs for patients with HCV ranged from $3,236 to $85,081, depending on the patients’ disease status and whether they were currently receiving treatment. Indirect costs for HCV patients were reported less frequently, but they ranged from $1,424 to $10,316 per patient per year. Utilities for patients with HCV ranged from 0.24 for patients experiencing severe adverse events to 0.89 for patients in sustained virological response. Recent economic models tended to use utility data taken from previous models or HTA submissions.
CONCLUSIONS: Numerous recent cost-effectiveness studies are available for HCV; however, many of the economic evaluations are based on previous models. There is a particular scarcity of updated country-specific utility data. As more treatment options become available, and more robust models are developed, enhanced utility and cost studies may be needed.
