Will Sofosbuvir/Ledipasvir (Harvoni) Be Cost-Effective and Affordable for Chinese Patients Infected with Hepatitis C Virus? An Economic Analysis Using Real-World Data
单位：[1]Second Liver Cirrhosis Diagnosis and Treatment Center, 302 Hospital, Beijing, China,[2]Beijing KeyLaboratory of Hepatitis C and Immunotherapy for Liver Diseases, Peking University People's Hospital, PekingUniversity Hepatology Institute, Beijing, China,[3]Division of Gastroenterology & Hepatology, Humanity &Health Medical Centre, Hong Kong, Hong Kong SAR, China,[4]The Translational Hepatology Institue, BeijingYou'an Hospital, Capital University ofMedicine, Beijing, China,[5]Department of Infectious Diseases, ShengjingHospital, China Medical University, Shenyang, China,中国医科大学附属盛京医院[6]Department of Infectious diseases, Shanghai RuijinHospital, Jiaotong University, School ofMedicine, Shanghai, China,[7]Key Laboratory ofMedical MolecularVirology, Huashan Hospital, Fudan University, Shanghai, China Institute of Biomedical Sciences, ShanghaiMedical College, Fudan University, Shanghai, China,[8]Department of Gastroenterology, Shanghai FirstPeople's Hospital, Shanghai Jiao Tong University School ofMedicine, Shanghai, China,[9]Department ofGastroenterology, Xinhua Hospital, Shanghai Jiaotong University School ofMedicine, Shanghai, China,[10]Liver Disease Center, Beijing Ditan Hospital, Capital University ofMedicine, Beijing, China,[11]Departmentof Infectious Diseases, Center for Liver Diseases, Peking University First Hospital, Beijing, China,[12]Institutefor Viral Hepatitis, Second Affiliated Hospital, Chongqing University ofMedical Sciences, Chongqing, China,[13]Department of Infectious Disease, Xijing Hospital, Fourth Military Medical University, Xi'an, China,[14]Department of Infection, Sichuan Provincial People's Hospital, Chengdu, Sichuan, China,四川省人民医院[15]Centerof Diagnosis and Treatment for Infectious Diseases of Chinese PLA, Tangdu Hospital, Fourth MilitaryMedical University, Xi’an, China,[16]Shanghai Liver Diseases Research Center, NanjingMilitary Command,Shanghai, China,[17]People’s Hospital, Shanghai Jiaotong University, School ofMedicine, Shanghai, China,[18]Department of Infectious Diseases, Henan Provincal People's Hospital, Zhengzhou University, Zhengzhou,China,[19]Department of Infectious Disease, Xinjiang Medical University First Affiliated Hospital, Urumqi,China,[20]Department of Digestive Diseases, Xijing Hospital, Fourth Military Medical University, Xi’an, China,[21]Liver Disease Center for Combined Traditional Chinese Medicine andWesternMedicine, 302 Hospital,Beijing, China,[22]State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory ofViral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University,Guangzhou, China,[23]Liver Disease Center, Beijing Friendship Hospital, Capital Medical University, Beijing,China,首都医科大学附属北京友谊医院[24]Department ofMicrobiology and Center of Infectious Disease, School of BasicMedical Sciences,Peking University Health Science Center, Beijing, China
Background Little is known on the cost-effectiveness of novel regimens for hepatitis C virus (HCV) compared with standard-of-care with pegylated interferon (pegIFN) and ribavirin (RBV) therapy in developing countries. We evaluated cost-effectiveness of sofosbuvir/ledipasvir for 12 weeks compared with a 48-week pegIFN-RBV regimen in Chinese patients with genotype 1b HCV infection by economic regions. Methods A decision analytic Markov model was developed to estimate quality-adjusted-life-years, lifetime cost of HCV infection and incremental cost-effectiveness ratios (ICERs). SVR rates and direct medical costs were obtained from real-world data. Parameter uncertainty was assessed by one-way and probabilistic sensitivity analyses. Threshold analysis was conducted to estimate the price which can make the regimen cost-effective and affordable. Results Sofosbuvir/ledipasvir was cost-effective in treatment-experienced patients with an ICER of US$21,612. It varied by economic regions. The probability of cost-effectiveness was 18% and 47% for treatment-naive and experienced patients, and it ranged from 15% in treatment-naive patients in Central-China to 64% in treatment-experienced patients in Eastern-China. The price of 12-week sofosbuvir/ledipasvir treatment needs to be reduced by at least 81% to US$18,185 to make the regimen cost-effective in all patients at WTP of one time GDP per capita. The price has to be US$105 to make the regimen affordable in average patients in China. Conclusion Sofosbuvir/ledipasvir regimen is not cost-effective in most Chinese patients with genotype 1b HCV infection. The results vary by economic regions. Drug price of sofosbuvir/ledipasvir needs to be substantially reduced when entering the market in China to ensure the widest accessibility.
基金：
Cheng Si-Yuan (China-International) Hepatitis Research Foundation; Humanity and Health Medical Group, HKSAR, China
第一作者单位：[1]Second Liver Cirrhosis Diagnosis and Treatment Center, 302 Hospital, Beijing, China,
共同第一作者：
通讯作者：
通讯机构：[1]Second Liver Cirrhosis Diagnosis and Treatment Center, 302 Hospital, Beijing, China,[3]Division of Gastroenterology & Hepatology, Humanity &Health Medical Centre, Hong Kong, Hong Kong SAR, China,
推荐引用方式(GB/T 7714)：
Chen Guo-Feng,Wei Lai,Chen Jing,et al.Will Sofosbuvir/Ledipasvir (Harvoni) Be Cost-Effective and Affordable for Chinese Patients Infected with Hepatitis C Virus? An Economic Analysis Using Real-World Data[J].PLOS ONE.2016,11(6):doi:10.1371/journal.pone.0155934.
APA：
Chen, Guo-Feng,Wei, Lai,Chen, Jing,Duan, Zhong-Ping,Dou, Xiao-Guang...&Lau, George.(2016).Will Sofosbuvir/Ledipasvir (Harvoni) Be Cost-Effective and Affordable for Chinese Patients Infected with Hepatitis C Virus? An Economic Analysis Using Real-World Data.PLOS ONE,11,(6)
MLA：
Chen, Guo-Feng,et al."Will Sofosbuvir/Ledipasvir (Harvoni) Be Cost-Effective and Affordable for Chinese Patients Infected with Hepatitis C Virus? An Economic Analysis Using Real-World Data".PLOS ONE 11..6(2016)
