Daclatasvir combined with asunaprevir is a cost-effective and cost-saving treatment for hepatitis C infection in China

Abstract

Aim: To evaluate the cost–effectiveness of the novel all-oral direct-acting antiviral regimen daclatasvir + asunaprevir (DUAL), versus interferon-based regimens for the treatment of chronic hepatitis C virus genotype 1b infection. Methods: Inputs for a lifetime Markov model were sourced from clinical trials and published literature. Outputs include disease management costs, life expectancy, quality-adjusted life-years and cost–effectiveness. Sensitivity analyses assessed the drivers of cost–effectiveness and sustained virologic response thresholds at which DUAL is cost-saving. Results: DUAL was associated with discounted incremental quality-adjusted life-years of 1.29–3.85 and incremental life-years of 0.85–2.59 per patient, with discounted lifetime cost savings of USD$1415–8525. Associated sustained virologic response rates could fall to 45.1–84.8%, while remaining dominant. Conclusion: Treatment with DUAL provides significant clinical benefit, while accruing lower lifetime costs.