Outcomes and Costs of Treating Hepatitis C Patients in the Era of First Generation Protease Inhibitors - Results from the PAN Study

PLoS One. 2016 Jul 28;11(7):e0159976. doi: 10.1371/journal.pone.0159976. eCollection 2016.

Abstract

1 objective: Chronic hepatitis C virus infections (HCV) cause a significant public health burden. Introduction of telaprevir (TVR) and boceprevir (BOC) has increased sustained virologic response rates (SVR) in genotype 1 patients but were accompanied by higher treatment costs and more side effects. Aim of the study was to assess outcomes and costs of treating HCV with TVR or BOC in routine care.

2 material and methods: Data was obtained from a non-interventional study. This analysis relates on a subset of 1,786 patients for whom resource utilisation was documented. Sociodemografic and clinical parameters as well as resource utilisation were collected using a web-based data recording system. Costs were calculated using official remuneration schemes.

3 results: Mean age of patients was 49.2 years, 58.6% were male. In treatment-naive patients SVR-rates of 62.2% and 55.7% for TVR and BOC were observed (prior relapser: 68.5% for TVR and 63.5% for BOC; prior non-responder: 45.6% for TVR and 39.1% for BOC). Treatment costs are dominated by costs for pharmaceuticals and range between €39,081 and €53,491. We calculated average costs per SVR of €81,347 (TVR) and €70,163 (BOC) in treatment-naive patients (prior relapser: 78,089 €/SVR for TVR and 82,077 €/SVR for BOC; prior non-responder: 116,509 €/SVR for TVR and 110,156 €/SVR for BOC). Quality of life data showed a considerable decrease during treatment.

4 conclusion: Our study is one of few investigating both, outcomes and costs, of treating HCV in a real-life setting. Data can serve as a reference in the discussion of increasing costs in recently introduced agents.

MeSH terms

  • Adult
  • Antiviral Agents / adverse effects
  • Antiviral Agents / economics
  • Antiviral Agents / therapeutic use*
  • Female
  • Health Care Costs*
  • Hepatitis C, Chronic / drug therapy*
  • Humans
  • Male
  • Middle Aged
  • Protease Inhibitors / adverse effects
  • Protease Inhibitors / economics
  • Protease Inhibitors / therapeutic use*
  • Quality of Life

Substances

  • Antiviral Agents
  • Protease Inhibitors

Grants and funding

Data were derived from: German Hepatitis C-Registry (DHC-R, Deutsches Hepatitis C Register) of the Deutsche Leberstiftung (German Liver Foundation), managed by Leberstiftungs-GmbH Deutschland in cooperation with the Association of German gastroenterologists in private practice (bng) with financial support from the German Center for Infection Research (DZIF) as well as from the companies AbbVie Deutschland GmbH & Co. KG, Bristol-Myers Squibb GmbH & Co.KGaA, Gilead Sciences GmbH, Janssen-Cilag GmbH, MSD Sharp & Dohme GmbH and Roche Pharma AG. The German Liver Foundation provided support in the form of service fees for authors [HPV], but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.