Micro-costing analysis of guideline-based treatment by direct-acting agents: the real-life case of hepatitis C management in Brazil
| Autor: | Carmen Romero, Chris Hyde, Julio Silva, Patrícia dos Santos Silva, Ruben Mujica-Mota, Valdilea G. Veloso, Rodolfo Castro, Alexandre Monken Avellar, Marcelino José Jorge, Hugo Perazzo, Rob Anderson |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Simeprevir
Liver Cirrhosis medicine.medical_specialty Pyrrolidines Sofosbuvir Genotype Proline Alpha interferon Micro-costing Chronic hepatitis C Antiviral Agents Drug Costs Telaprevir 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Boceprevir Ribavirin Medicine Humans 030212 general & internal medicine lcsh:RC799-869 Activity-based costing business.industry Gastroenterology Imidazoles Interferon-alpha Valine General Medicine Hepatitis C Guideline Hepatitis C Chronic medicine.disease 3. Good health Treatment chemistry Emergency medicine Costs and Cost Analysis 030211 gastroenterology & hepatology lcsh:Diseases of the digestive system. Gastroenterology Carbamates business Oligopeptides Brazil medicine.drug Research Article |
| Zdroj: | BMC Gastroenterology, Vol 17, Iss 1, Pp 1-11 (2017) BMC Gastroenterology |
| ISSN: | 1471-230X |
| Popis: | Background Eradication of hepatitis C virus (HCV) using direct-acting agents (DAA) has been associated with a financial burden to health authorities worldwide. We aimed to evaluate the guideline-based treatment costs by DAAs from the perspective of the Brazilian Ministry of Health (BMoH). Methods The activity based costing method was used to estimate the cost for monitoring/treatment of genotype-1 (GT1) HCV patients by the following strategies: peg-interferon (PEG-IFN)/ribavirin (RBV) for 48 weeks, PEG-IFN/RBV plus boceprevir (BOC) or telaprevir (TEL) for 48 weeks, and sofosbuvir (SOF) plus daclastavir (DCV) or simeprevir (SIM) for 12 weeks. Costs were reported in United States Dollars without (US$) and with adjustment for purchasing power parity (PPP$). Drug costs were collected at the National Database of Health Prices and an overview of the literature was performed to assess effectiveness of SOF/DCV and SOF/SIM regimens in real-world cohorts. Results Treatment costs of GT1-HCV patients were PPP$ 43,176.28 (US$ 24,020.16) for PEG-IFN/RBV, PPP$ 71,196.03 (US$ 39,578.23) for PEG-IFN/RBV/BOC and PPP$ 86,250.33 (US$ 47,946.92) for PEG-IFN/RBV/TEL. Treatment by all-oral interferon-free regimens were the less expensive approach: PPP$ 19,761.72 (US$ 10,985.90) for SOF/DCV and PPP$ 21,590.91 (US$ 12,002.75) for SOF/SIM. The overview reported HCV eradication in up to 98% for SOF/DCV and 96% for SOF/SIM. Conclusion Strategies with all oral interferon-free might lead to lower costs for management of GT1-HCV patients compared to IFN-based regimens in Brazil. This occurred mainly because of high discounts over international DAA prices due to negotiation between BMoH and pharmaceutical industries. Electronic supplementary material The online version of this article (10.1186/s12876-017-0676-8) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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