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Public Health Pharmacogenomics

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Cost-Effectiveness of IL28Β Genotype-Guided Protease Inhibitor Triple Therapy versus Standard of Care Treatment in Patients with Hepatitis C Genotypes 2 or 3 Infection

Bock J.A.a · Fairley K.J.b · Smith R.E.b · Maeng D.D.c · Pitcavage J.M.c · Inverso N.A.b · Williams M.S.d

Author affiliations

aWeis Center for Research, bDepartment of Gastroenterology, cCenter for Health Research, and dGenomic Medicine Institute, Geisinger Medical Center, Danville, Pa., USA

Corresponding Author

Marc S. Williams

Genomic Medicine Institute, Geisinger Medical Center

100 N. Academy Avenue

Danville, PA 17822 (USA)

E-Mail mswilliams1@geisinger.edu

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Public Health Genomics 2014;17:306-319

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Background/Aims: Triple therapy [adding protease inhibitors to standard of care (SOC)] dramatically increases treatment response in selected patients with hepatitis C virus (HCV). Interleukin 28B (IL28Β) genotyping helps predict responsiveness in these patients; however, the economic implications of IL28Β genotyping in HCV genotype 2 or 3 infected patients are unknown. Short- and long-term costs and outcomes of SOC therapy were calculated and used to determine the cost-effectiveness thresholds for using triple therapy in HCV genotype 2 or 3 infected patients. Methods: Costs and outcomes were calculated by conducting cohort simulations on decision trees modeling SOC and triple therapy. Quality-adjusted life expectancies and long-term costs were predicted through Markov modeling. Results: For triple therapy to be cost-effective, sustained virologic response (SVR) rates must improve (depending on age) by 7.91-11.11 and 9.06-12.8% for HCV genotype 2 and 3 cohorts, respectively. When triple therapy is guided by 2 IL28Β variants, a 2.63-3.72% improvement in SVR is needed for cost-effectiveness, and when guided by only one variant, a 1.4-8.91% improvement is needed. Conclusions: Markov modeling revealed that modest increases in SVR rates from IL28Β-guided triple therapy can lead to both lower costs and better health outcomes than SOC therapy in the long run.

© 2014 S. Karger AG, Basel


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Article / Publication Details

First-Page Preview
Abstract of Public Health Pharmacogenomics

Published online: September 18, 2014
Issue release date: December 2014

Number of Print Pages: 14
Number of Figures: 4
Number of Tables: 2

ISSN: 1662-4246 (Print)
eISSN: 1662-8063 (Online)

For additional information: https://www.karger.com/PHG

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