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(Reference retrieved automatically from SciELO through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Cost-effectiveness analysis is a mandatory strategy for health systems: evidence from a study involving therapies for hepatitis C

Full text
Author(s):
João Paulo Vilela Rodrigues ; Maurílio de Souza Cazarim [2] ; Silvana Gama Florencio Chachá [3] ; Ana de Lourdes Candolo Martinelli [4] ; Leonardo Régis Leira Pereira [5]
Total Authors: 5
Document type: Journal article
Source: Cadernos de Saúde Pública; v. 36, n. 2 2020-01-31.
Abstract

Abstract: Cost-effectiveness analysis is essential in health decision making. Several countries use it as synthesis of evidence to incorporate health technologies. The protease inhibitors (PI) boceprevir (BOC) and telaprevir (TVR) are indicated for chronic hepatitis C treatment and were incorporated in guidelines worldwide. Pre-marketing clinical trials showed higher sustained virological response rates in relation to previous therapies, but the incorporation of PIs generated a significant financial impact. The aim of this study was to discuss the relevance of cost-effectiveness analysis through a study that involved the inclusion of PIs in a clinical protocol. The analysis was part of a real-life study that included patients infected with hepatitis C virus genotype 1 treated in a tertiary university hospital in Brazil. Triple therapies (TT) with ribavirin (RBV), peginterferon α-2a (Peg-INF α-2a) and BOC or TVR were compared to dual therapy with RBV and Peg-INF α-2a. Sensitivity analysis of the cost-effectiveness ratio indicated an 88.2% chance of TTs presenting a higher cost per cure. The incremental cost-effectiveness ratios (ICER) exceeded the Brazilian gross domestic product (GDP) per capita by three times in all proposed scenarios. The sensitivity of ICER showed an 88.4% chance of TT not being cost-effective. The impact of PI incorporation was negative and the conduct about this could have been different if a previous cost-effectiveness analysis had been conducted. (AU)

FAPESP's process: 16/03584-1 - DEVELOPMENT AND VALIDATION OF A PHARMACOECONOMIC TOOL FOR THE IMPLEMENTATION OF PHARMACEUTICAL CARE FOR HYPERTENSIVE PATIENTS IN THE PUBLIC HEALTH SYSTEM OF BRAZIL
Grantee:Maurilio de Souza Cazarim
Support Opportunities: Scholarships in Brazil - Doctorate
FAPESP's process: 17/21240-0 - Development and validation of a pharmacoeconomic tool for decision making in the implementation of pharmaceutical care for hypertensive patients in the public health system
Grantee:Maurilio de Souza Cazarim
Support Opportunities: Scholarships abroad - Research Internship - Doctorate