PS 1-13
BUDGET IMPACT ANALYSIS FOR THE TREATMENT OF GENOTYPE 1 CHRONIC HEPATITIS C IN GERMANY WITH OMBITASVIR / PARITAPREVIR / RITONAVIR AND DASABUVIR
World-wide, approximately 500,000 people die each year from hepatitis C-related liver diseases. New direct acting antivirals achieve high sustained virological response, therefore they are assumed to reduce the risk of death from liver cancer and cirrhosis. Due to high antiviral treatment costs, budget impact analyses (BIA) are increasingly required to address the expected changes in the expenditure after the adoption of a new HCV regimen. This BIA aims to estimate the expected changes in the expenditures after the adoption of the new regimens ombitasvir/paritaprevir/ritonavir+dasabuvir+/-ribavirin (OBV/PTV/r+DSV±R) in patients with chronic hepatitis C (CHC) genotype 1 infection in Germany.
Method:
In this BIA, the target populations are treatment-naïve and treatment-experienced CHC patients defined by genotype, age, and fibrosis distribution. Treatments that are currently reimbursed in Germany are included in this analysis. The BIA includes the assessment of the (1) target population, (2) direct medical costs associated with antiviral HCV treatment under market-share scenarios for comparator regimens (“environment without OBV/PTV/r+DSV±R”), (3) cost in the “environment with OBV/PTV/r+DSV±R”, and (4) net budget impact (difference in costs of both environments). We adopted the payer’s perspective, with a 5-year time horizon and annual budgeting periods. A series of one-way-sensitivity analyses were performed.
Result:
The net budget impact adopting OBV/PTV/r+DSV±R over the budget time horizon was estimated to be ‑129 million Euros, representing a relative budget decrease of more than 11% compared to the “environment without OBV/PTV/r+DSV±R”. This predicted budget decrease is mainly driven by reduced antiviral-drug costs in prevalent patients in the “environment with OBV/PTV/r+DSV±R ” compared to the “environment without OBV/PTV/r+DSV±R“, due to the lower price per therapy day of OBV/PTV/r+DSV±R. The sensitivity analyses demonstrated the robustness of the results. The estimated prevalence and incidence of detected CHC cases and the proportion of CHC patients indicated for treatment among all detected showed the largest impact.
Conclusion:
The BIA results for Germany showed that based on the estimated hypothetical market shares, the adoption of OBV/PTV/r+DSV±R will likely generate relative budget savings over a 5-year time horizon.