PMID- 30288304
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220321
IS  - 2059-5166 (Electronic)
IS  - 2059-5166 (Linking)
VI  - 1
DP  - 2016
TI  - A new paradigm evaluating cost per cure of HCV infection in the UK.
PG  - 2
LID - 10.1186/s41124-016-0002-z [doi]
LID - 2
AB  - BACKGROUND: New interferon (IFN)-free treatments for hepatitis C are more 
      effective, safer but more expensive than current IFN-based therapies. Comparative 
      data of these, versus current first generation protease inhibitors (PI) with 
      regard to costs and treatment outcomes are needed. We investigated the real-world 
      effectiveness, safety and cost per cure of 1st generation PI-based therapies in 
      the UK. METHODS: Medical records review of patients within the HCV Research UK 
      database. Patients had received treatment with telaprevir or boceprevir and 
      pegylated interferon and ribavirin (PR). Data on treatment outcome, healthcare 
      utilisation and adverse events (AEs) requiring intervention were collected and 
      analysed overall and by subgroups. Costs of visits, tests, therapies, adverse 
      events and hospitalisations were estimated at the patient level. Total cost per 
      cure was calculated as total median cost divided by SVR rate. RESULTS: 154 
      patients from 35 centres were analysed. Overall median total cost per cure was 
       pound44,852 (subgroup range,:  pound35,492 to  pound107,288). Total treatment costs were 
      accounted for by PI: 68.3 %, PR: 26.3 %, AE management: 5.4 %. Overall SVR was 
      62.3 % (range 25 % to 86.2 %). 36 % of patients experienced treatment-related AEs 
      requiring intervention, 10 % required treatment-related hospitalisation. 
      CONCLUSIONS: This is the first UK multicentre study of outcomes and costs of 
      PI-based HCV treatments in clinical practice. There was substantial variation in 
      total cost per cure among patient subgroups and high rates of treatment-related 
      discontinuations, AEs and hospitalisations. Real world safety, effectiveness and 
      total cost per cure for the new IFN free combinations should be compared against 
      this baseline.
FAU - Barclay, Stephen T
AU  - Barclay ST
AD  - 1Walton Liver Clinic, Glasgow Royal Infirmary, Glasgow, UK. GRID: grid.411714.6. 
      ISNI: 0000000098257840
FAU - Cooke, Graham S
AU  - Cooke GS
AD  - 2Division of Infectious diseases, Imperial College London, London, UK. GRID: 
      grid.7445.2. ISNI: 0000000121138111
FAU - Holtham, Elizabeth
AU  - Holtham E
AD  - 3NIHR Nottingham Digestive Diseases Biomedical Research Unit, University of 
      Nottingham, Nottingham, UK. GRID: grid.4563.4. ISNI: 0000000419368868
FAU - Gauthier, Aline
AU  - Gauthier A
AD  - Amaris Ltd, London, UK.
FAU - Schwarzbard, Jeremie
AU  - Schwarzbard J
AD  - Amaris Ltd, London, UK.
FAU - Atanasov, Petar
AU  - Atanasov P
AD  - Amaris Ltd, London, UK.
FAU - Irving, William L
AU  - Irving WL
AD  - 3NIHR Nottingham Digestive Diseases Biomedical Research Unit, University of 
      Nottingham, Nottingham, UK. GRID: grid.4563.4. ISNI: 0000000419368868
AD  - 5Microbiology, Queen's Medical Centre, Nottingham, NG7 2UH UK. GRID: 
      grid.415598.4. ISNI: 0000000406414263
CN  - HCV Research UK
LA  - eng
PT  - Journal Article
DEP - 20160414
PL  - England
TA  - Hepatol Med Policy
JT  - Hepatology, medicine and policy
JID - 101699552
PMC - PMC5898515
OTO - NOTNLM
OT  - Cost
OT  - Hepatitis C
OT  - Protease inhibitors
OT  - SVR
EDAT- 2016/04/14 00:00
MHDA- 2016/04/14 00:01
PMCR- 2016/04/14
CRDT- 2018/10/06 06:00
PHST- 2015/08/13 00:00 [received]
PHST- 2016/03/16 00:00 [accepted]
PHST- 2018/10/06 06:00 [entrez]
PHST- 2016/04/14 00:00 [pubmed]
PHST- 2016/04/14 00:01 [medline]
PHST- 2016/04/14 00:00 [pmc-release]
AID - 2 [pii]
AID - 10.1186/s41124-016-0002-z [doi]
PST - epublish
SO  - Hepatol Med Policy. 2016 Apr 14;1:2. doi: 10.1186/s41124-016-0002-z. eCollection 
      2016.