THE COST OF STOPPING (FUTILITY) RULES TELAPREVIR AND BOCEPREVIR IN THE TREATMENT OF GENOTYPE 1 HEPATITIS C PATIENTS IN BRAZIL

Author(s)

Morais AD*, Pereira ML Janssen Cilag Farmaceutica, São Paulo, Brazil

OBJECTIVES: To estimate the cost of treatment discontinuation due to label stopping (futility) rules of telaprevir (TVR) and boceprevir (BOC) triple therapy in Brazilian public (SUS) and private healthcare system (SS). METHODS: Treatment costs considered drug acquisition costs from a public and private payer perspective in Brazil. Stopping rules (SR) were defined according to the label of each drug. For TVR the SR were defined at week4 (SR WK4)  and at week 12 (SR WK12) as viral load (VL) > 1.000 IU/ML. For BOC, SR were defined at week 12 (SR WK12) as VL >100 UI/mL and at week 24 (SR WK24) as detectable VL. Patients eligible for the SR were gathered for naïve and experienced patients from the respective phase 3 trials.  As data for SR WK24 was not published for BOC in naïve patients it was assumed to be the same as SR WK12 and a deterministic sensitivity analysis was carried out. RESULTS:  Under the SUS perspective, the average cost of naïve patients interrupting treatment with TVR was R$ 670 compared to an average cost of R$ 3.396 per interrupted treatment with BOC, and for treatment experienced patients, TVR had an average cost of R$ 352 compared to an average cost of R$ 3.041 for BOC per patient meeting the SR.  Under the SS perspective, TVR had an average cost of R$ 1.433 per interrupted naïve treatment and R$ 753 per interrupted treatment in experienced patients and BOC had an average treatment cost of R$ 8.305 per naïve patient interrupting treatment and R$ 4.753 per interrupted treatment in experienced patients. CONCLUSIONS: BOC had higher costs associated with treatment futility when compared to TVR, especially in treatment experienced patients, in both the public and private healthcare systems in Brazil.

Conference/Value in Health Info

2013-11, ISPOR Europe 2013, The Convention Centre Dublin

Value in Health, Vol. 16, No. 7 (November 2013)

Code

PIN27

Topic

Economic Evaluation

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis

Disease

Infectious Disease (non-vaccine)

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