PMU20 Use of Need to HCV Retreatment As Cost-Effectiveness Analysis Criterion in Health Economics Analysis in Moscow

Abstract

OBJECTIVE: to study the options of antiviral therapy with direct antiviral drugs and its economic expression for the period 2017-2019 according to the data of the Moscow Department of Health on the drug supply for 6936 unique patients with chronic hepatitis C virus (HCV). Cost analysis was carried out from the position of the payer - the Moscow Department of Health. Calculation of costs for drugs was based on the registered purchase prices of drugs. The average price of each antiviral therapy (AVT) was calculated by counting the average value of the sums of prices of all drugs included in this AVT, of all unique database records. The average level of cost for all types of AVT with direct antiviral agents (DAA) amounted to 8563,31€. The most commonly used Daclatasvir + Asunaprevir (Dac+Asu). The average cost of this AVT per patient as the first-line antiviral therapy was for 731.13€ lower than the ombitasvir/paritaprevir/ritonavir + dasabuvir (3D), and for 730.66€ higher than the elbasvir/grazoprevir (Elb/Grz).The need for retreatment for the Dac+Asu was 8.4%, and for the 3D, Elb/Grz and glecaprevir/pibrentasvir (Gle/Pib) - 0.58%, 0% and 0%, respectively. A greater difference from the average cost was recorded for the Sofosbuvir+Daclatasvir (Sof+Dac), Sofosbuvir+Simeprevir (Sof+Sim): which entailed the excess of the costs of treating one patient with this distribution of AVT and financial resources by 3143.52€ and 2348.28 €, respectively, which is 1.36 and 1, 27 times the average cost of all prices for antiviral treatment sets. The median frequency of re-appointment of AVT DAA averaged 7.65%. Budget costs for the second and subsequent attempts of AVT increased by 1151207.82€. The increase in the number of AVT attempts significantly increases the accumulated costs of treating a patient, which in turn leads to an increase in the burden on the budget of the healthcare system.