Cost-effectiveness of novel treatment of hepatitis C virus in Lebanese patients
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Background Limited data is available on Hepatitis C disease prevalence, treatment initiation and its cost-effectiveness in Lebanon and the whole Middle East. Objective The aim of the study is to assess whether initiation of novel Direct Acting Antiviral agents (DAAs) at early stage of hepatitis C is cost-effective in Lebanese patients. Setting Lebanon. Methods This modeling study was conducted from the perspective of Lebanese third party payers, where existing practice is based on international guidelines for the diagnosis and treatment of diseases. The model assessed cost-effectiveness of early versus delayed DAAs treatment in a standard patient upon HCV diagnosis. Medical costs were valued using in-house database. Main outcome measures Incremental Cost-Effectiveness Ratio (ICER) per QALY and per life-year extended. Results Treatment at early HCV disease stage has led to an ICER of 587 euro per QALY gained throughout the course of the disease. Outcomes of early treatment with DAAs upon HCV diagnosis led to an incremental cost of 27,268 euro per QALY gained at first year of treatment, and of 1527 euro per additional life-year extended. Sensitivity analysis showed that a 25% decrease in the cost of dual drug option resulted in a decrease of incremental cost to 16,982 euro per QALY gained at first year of treatment with DAAs upon early HCV diagnosis. Conclusion Decision makers are encouraged to reinforce the need to screen for HCV and initiate novel treatment at early disease stage in the Lebanese healthcare system.
KeywordsCost-effectiveness Delayed treatment Direct acting anti-viral agents Early treatment Hepatitis C virus Lebanon QALYs
Authors would like to acknowledge Dr Natalia Argente, at University of Pompeu Fabra, for providing feedbacks on study design, and Dr Lamis Karaoui, at the Lebanese American University, for editing the writing of the manuscript.
Conflicts of interest
All authors declare that they have no conflicts of interest.
- 2.Centers for Disease Control and Prevention. Surveillance for viral hepatitis—United States, 2012. http://www.cdc.gov/hepatitis/statistics/2012surveillance/commentary.htm. Accessed 20 Dec 2016.
- 8.Daw MA, Dau AA. Hepatitis C virus in Arab world: a state of concern. Sci World J. 2012;2012:719494.Google Scholar
- 9.American Association for the Study of Liver Diseases (AASLD) and Infectious Diseases Society of America (IDSA). Recommendations for Testing, Managing, and Treating Hepatitis C. 2017. http://www.hcvguidelines.org. Accessed 5 Apr 2017.
- 11.Obach D, Deuffic-Burban S, Esmat G, Anwar WA, Dewedar S, Canva V, et al. Effectiveness and cost-effectiveness of immediate versus delayed treatment of hepatitis C virus-infected patients in a country with limited resources: the case of Egypt. Clin Infect Dis. 2014;58(8):1064–71.CrossRefPubMedGoogle Scholar