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首页> 外文期刊>ClinicoEconomics and Outcomes Research >Budget impact analysis of sofosbuvir-based regimens for the treatment of HIV/HCV-coinfected patients in northern Italy: a multicenter regional simulation
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Budget impact analysis of sofosbuvir-based regimens for the treatment of HIV/HCV-coinfected patients in northern Italy: a multicenter regional simulation

机译：基于索非布韦的方案在意大利北部治疗HIV / HCV感染患者的预算影响分析：多中心区域模拟

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Objectives: Chronic hepatitis C virus (HCV) is a leading cause of hospitalization and death in populations coinfected with human immunodeficiency virus (HIV). Sofosbuvir (SOF) is a pan-genotypic drug that should be combined with other agents as an oral treatment for HCV. We performed a 5-year horizon budget impact analysis of SOF-based regimens for the management of HIV/HCV-coinfected patients. Methods: A multicenter, prospective evaluation was conducted, involving four Italian Infectious Diseases Departments (Galliera, San Martino, Sanremo, and La Spezia). All 1,005 genotype-coinfected patients (30% cirrhotics) under observation were considered (patients in all disease-stages were considered: chronic hepatitis C, cirrhosis, transplant, hepatocellular carcinoma). Disease stage costs per patient were collected; the expected disease progression in the absence of treatment and sustained virological response (SVR) success rate for SOF-based regimens were calculated based on the literature and expert opinion. Drug prices were based on what the National Health Service paid for them. The comparison of "no treatment" disease progression costs versus the economic impact of SOF-based regimens was investigated. Results: Over the following 5 years, the disease progression scenario resulted in direct costs of approximately €54 million. Assuming an SVR success rate of 90%, average SOF-based regimens cost up to €50,000 per person, resulting in a final cost of more than €56 million, so this option is not economically viable. At the average price of €12,000, SOF-based regimens, expense was €17 million, saving 68%. At this price level, the economic resources invested in treating mild to moderate fibrosis stage patients would be equal to the amount of direct costs of disease management in this stage, resulting in a valid return of investment in the short-term. Conclusion: Given the high rates of SVR, in the Italian Healthcare System, SOF-based regimens, price is a determinant and a predictor of the overall cost for the Hepatitis C patient's management. At the average price per therapy of €12,000 over the next 5 years, SOF-based regimens are becoming highly sustainable.
机译：目的：慢性丙型肝炎病毒（HCV）是合并感染人类免疫缺陷病毒（HIV）的人群中住院和死亡的主要原因。 Sofosbuvir（SOF）是一种泛基因型药物，应与其他药物联合口服治疗HCV。我们对基于SOF的治疗HIV / HCV感染患者的方案进行了为期5年的预算预算影响分析。方法：进行了一个多中心的前瞻性评估，涉及四个意大利传染病部门（加利拉，圣马蒂诺，圣雷莫和拉斯佩齐亚）。考虑了所有1,005位基因型合并感染的患者（30％的肝硬化患者）（考虑了所有疾病阶段的患者：慢性丙型肝炎，肝硬化，移植，肝细胞癌）。收集每位患者的疾病阶段费用;基于文献和专家意见，计算了在没有治疗的情况下预期的疾病进展以及基于SOF的方案的持续病毒学应答（SVR）成功率。药品价格是根据国家卫生局支付的价格确定的。研究了“不治疗”疾病进展成本与基于SOF方案的经济影响之间的比较。结果：在接下来的5年中，疾病进展情景导致直接成本约5400万欧元。假设SVR成功率为90％，则基于SOF的平均治疗方案每人的费用高达50,000欧元，最终费用超过5,600万欧元，因此这种选择在经济上不可行。以SOF为基础的治疗方案平均价格为12,000欧元，费用为1,700万欧元，节省了68％。在这个价格水平上，用于治疗轻中度纤维化阶段患者的经济资源将等于该阶段疾病管理的直接成本，从而在短期内获得有效的投资回报。结论：鉴于SVR的高发生率，在意大利医疗保健系统中，基于SOF的治疗方案，价格是决定丙型肝炎患者治疗总成本的决定因素和预测因素。未来5年内，基于SOF的治疗方案将以平均每疗程12,000欧元的价格变得高度可持续。

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