Micro-costing analysis of guideline-based treatment by direct-acting agents: the real-life case of hepatitis C management in Brazil.
Micro-costing analysis of guideline-based treatment by direct-acting agents: the real-life case of hepatitis C management in Brazil.
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DOI：
10.1186/s12876-017-0676-8
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发表时间：
2017-11-23
影响因子：
2.4
通讯作者：
Castro R
中科院分区：
文献类型：
--
作者：
Perazzo H;Jorge MJ;Silva JC;Avellar AM;Silva PS;Romero C;Veloso VG;Mujica-Mota R;Anderson R;Hyde C;Castro R
使用直接作用剂 (DAA) 根除丙型肝炎病毒 (HCV) 会给全世界卫生当局带来经济负担。我们的目的是从巴西卫生部 (BMoH) 的角度评估 DAA 基于指南的治疗成本。基于活动的成本计算方法用于通过以下策略估算基因型 1 (GT1) HCV 患者的监测/治疗成本：聚乙二醇干扰素 (PEG-IFN)/利巴韦林 (RBV) 48 周，PEG-IFN/RBV 加博普瑞韦 (BOC) 或特拉匹韦 (TEL) 48 周，以及索磷布韦 (SOF) 加达拉他韦 (DCV) 或西米普韦 (SIM) 12 周。成本以美元报告，不含购买力平价 (PPP$) 和调整后的美元 (US$)。药物成本收集在国家卫生价格数据库中，并对文献进行了概述，以评估 SOF/DCV 和 SOF/SIM 方案在现实世界队列中的有效性。 GT1-HCV 患者的治疗费用，PEG-IFN/RBV 的治疗费用为 PPP$ 43,176.28 (24,020.16 美元)，PEG-IFN/RBV/BOC 的 PPP$ 71,196.03 (39,578.23 美元)，PEG-IFN/RBV/BOC 的 PPP$ 86,250.33 (47,946.92 美元)。 PEG-IFN/RBV/电话。全口服无干扰素方案治疗是较便宜的方法：SOF/DCV 的 PPP 为 19,761.72 美元（10,985.90 美元），SOF/SIM 的 PPP 为 21,590.91 美元（12,002.75 美元）。概述报告指出，SOF/DCV 的 HCV 根除率高达 98%，SOF/SIM 的 HCV 根除率高达 96%。在巴西，与基于干扰素的治疗方案相比，所有口服无干扰素的策略可能会降低 GT1-HCV 患者的治疗成本。出现这种情况的主要原因是 BMoH 与制药行业之间的谈判导致国际 DAA 价格大幅折扣。本文的在线版本 (10.1186/s12876-017-0676-8) 包含补充材料，可供授权用户使用。
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). 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. 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. 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. The online version of this article (10.1186/s12876-017-0676-8) contains supplementary material, which is available to authorized users.
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影响因子：
29.4
作者：
Nahon, Pierre;Bourcier, Valerie;Roudot-Thoraval, Francoise
通讯作者：
Roudot-Thoraval, Francoise
影响因子：
29.4
作者：
Hezode, Christophe;Fontaine, Helene;Bronowicki, Jean-Pierre
通讯作者：
Bronowicki, Jean-Pierre
影响因子：
4.5
作者：
Mesquita, Fabio;Santos, Melina Erica;Moscoso Naveira, Marcelo Contardo
通讯作者：
Moscoso Naveira, Marcelo Contardo
影响因子：
3.1
作者：
Jayasekera, Channa R.;Perumpail, Ryan B.;Ahmed, Aijaz
通讯作者：
Ahmed, Aijaz
影响因子：
1
作者：
Modenesi, Andre De Melo;Modenesi, Rui Lyrio
通讯作者：
Modenesi, Rui Lyrio