Objective The combination of pegylated interferon (PEG-IFN), ribavirin (RBV) and a protease inhibitor (PI) has been approved in summer 2011 for the treatment of genotype 1 (G1) hepatitis C virus (HCV)-infected patients, with a substantially improved efficacy. The aim of this study was to estimate the number of G1 patients to be treated in France in 2012 and associated costs.
Methods A published model of HCV and data on PEG-IFN sales were used to estimate patients needing treatment using three scenarios. (1) HCV screening rate unchanged versus 2010; proportion of treated F0–F1 patients unchanged, proportion of treated F2–F4 patients increased to the current proportion of treated F2–F4 G2/3 patients. (2) Scenario 1 but the proportion of treated F0–F1 patients increased to the current proportion of treated F0–F1 G2/3 patients. (3) Scenario 2 but a 5% increase in the HCV screening rate. To estimate cost, treatment duration was multiplied by drug unit cost. Probabilities corresponding to treatment duration were estimated based on liver fibrosis stage, treatment-naive or experienced status of the patient and virological response kinetics on treatment.
Results Compared with the 5100 G1 patients treated in 2010, the number of G1 patients receiving treatment in 2012 would be 15 000 in scenario 1, 18 300 in scenario 2 and 19 400 in scenario 3, among whom 2.5–3.7% may receive PEG-IFN/RBV and 96.3–97.5% PEG-IFN/RBV+PI. Costs associated with this regimen use ranged from 497 to 638 million Euros.
Conclusion These model-based estimates indicate that new anti-HCV treatments may result in a three- to fourfold increase in the number of G1 patients to be treated in France in 2012.
- Chronic hepatitis C
- genotype 1
- model-based analysis
- pegylated interferon and ribavirin
- protease inhibitor
- HCV, hepatitis C
- liver biopsy
- liver cirrhosis
- hepatitis B
- hepatitis D
- HIV/AIDS, infectious disease
- HIV-related gastrointestinal disease
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Funding This work was supported by the Agence nationale de recherches sur le sida et les hépatites virales (ANRS).
Competing interests SD-B received grants from Roche, Janssen Pharmaceuticals and Schering-Plough. PM was a paid speaker at symposiums held by Roche, Schering-Plough, Gilead Sciences and Bristol-Myers Squibb. He is an investigator for Roche, Schering-Plough, Bristol-Myers Squibb, Gilead Sciences, Vertex Pharmaceuticals and Bayer Healthcare, a member of the French Board of Experts in Hepatology for Roche, Schering-Plough, Gilead Sciences, Bayer Healthcare and Bristol-Myers Squibb, and a consultant for Gilead Sciences and Vertex Pharmaceuticals. SP is a board member of BMS, Boehringer Ingelheim, Tibotec/Janssen Pharmaceuticals, Gilead, Roche, Merck/Schering-Plough and Abbott; he was a speaker for Glaxo-SmithKline, Bristol-Myers Squibb, Boehringer Ingelheim, Tibotec/Janssen Pharmaceuticals, Gilead, Roche and Merck/Schering-Plough, and has received grants from Bristol-Myers Squibb, Gilead, Roche and Merck/Schering-Plough. CL, none. FR-T is an investigator for Roche and Schering-Plough. J-CD, none. DD has been a consultant for Janssen Pharmaceuticals. YY has received travel grants, honoraria for presentations at workshops and consultancy honoraria from Bristol-Myers Squibb, Gilead, Glaxo-SmithKline, Merck, Pfizer, Roche and Tibotec.
Provenance and peer review Not commissioned; externally peer reviewed.