BUDGET IMPACT ANALYSIS INCLUDING OMBITASVIR/PARITAPREVIR/RITONAVIR AND DASABUVIR FOR THE TREATMENT OF CHRONIC HEPATITIS C IN FRANCE

Purpose:

Patients chronically infected with hepatitis C virus (HCV) often develop liver cirrhosis and liver cancer. New direct acting antivirals can cure most of these patients and reduce the risk of death from liver cancer and cirrhosis, but antiviral treatment costs are high. The objective of this budget impact analysis (BIA) is to estimate the expected changes in the expenditures of the health care system after the adoption of the new regimen ombitasvir/paritaprevir/ritonavir+dasabuvir+/-ribavirin (OBV/PTV/r+DSV±R) in patients with chronic HCV genotype 1 (GT1) infection in France.

Method(s):

The target populations comprise treatment-naive and treatment-experienced GT1 HCV patients defined by age and fibrosis distribution. This BIA includes antiviral treatments that are currently reimbursed in France. The assessment framework includes (1) target population, (2) costs associated with antiviral HCV treatment under market-share scenarios for comparator regimens (“environment without OBV/PTV/r+DSV±R”), (3) costs in the “environment with OBV/PTV/r+DSV±R”, and (4) calculation of net budget impact (difference of both environments). The BIA is conducted from the payer’s perspective, with a 3-year time horizon and annual budgeting periods. One-way sensitivity analyses are performed on market shares.

Result(s):

In the first year, the predicted net budget impact is -65.5 million Euro (-8%), i.e., the total estimated budget decreases adopting OBV/PTV/r+DSV±R. These net savings are mainly caused by reduced antiviral drug costs. In the second and third year, the net predicted budget impacts are -90.7 million Euro (i.e., 10.2% second year) and -96.6 million Euro (i.e., 10.9% third year) based on assumed market shares and increased uptake of OBV/PTV/r+DSV±R. The total budget savings are 252.8 million Euros over 3 years. With ±20% change in OBV/PTV/r+DSV±R market shares, the total budget savings over 3 years vary between 216.8 and 287.9 million Euro.

Conclusion(s):

Based on the estimated market shares, our BIA shows that the adoption of OBV/PTV/r+DSV±R for the treatment of patients chronically infected with HCV GT1 in France will likely generate cost savings during the budgetary time horizon of 3 years.