P0807 : The quality of life journey for patients with chronic hepatitis C: From interferon and ribavirin to interferon-free and ribavirin-free regimens

Abstract

relative to ‘watchful waiting’ (i.e. no HCV treatment) at different fibrosis stages are not well understood. The aim of this study is to quantify these survival benefits in terms of life-years (LYs) and quality-adjusted life years (QALYs) and to monetize their value. Methods: A Markov disease utility state-transition model was developed to estimate survival benefits accruing from no HCV treatment and treatment with the AbbVie regimen from the perspective of a private US payer. Survival outcomes were evaluated over a lifetime horizon with annual cycles and discounted at 3% per year. Transition probabilities and health utilities associated with 14 health states were obtained from published literature. The model population was composed of treatment-naive patients aged 52 years and treatment experienced patients aged 54 years with GT1 chronic hepatitis C. About 60% of the patient population was male. Clinical efficacy and disutilities associated with HCV treatment were extracted from AbbVie trials. Survival benefits were monetized based on an assumed valuation of $100,000 per LY or QALY suggested in the literature. Results: Compared to watchful waiting, the lifetime survival benefits of HCV treatment with the AbbVie regimen vary substantially by stage of treatment initiation. For treatment-naive patients, the value of survival benefits increases six-fold from $62,987 with initiation at F0 to $398,766 with initiation at F4 (see Table). The quality-adjusted value of these survival benefits increases nearly three-fold from $180,460 with initiation at F0 to $508,723 with initiation at F4. Regardless of the fibrosis stage when treatment is initiated, treatment-experienced patients have 1%>6% less survival benefits than treatment-naive patients. Conclusions: The AbbVie 3D regimen prolongs the survival of chronic HCV patients and improves quality of life. The survival costs of watchful waiting are substantially greater at more advanced levels of liver fibrosis.