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Costs of Telaprevir-based Triple Therapy Including Adverse Event Management at the Mount Sinai Medical Center, NY $189,000 per SVR
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Reported by Jules Levin
AASLD 2013 Nov 1-4 Wash DC
Kian Bichoupan, Valerie Martel-Laferriere, David Sachs, Michel Ng, Emily Schonfeld, Alexis Pappas, James Crismale, Alicia Stivala,
Viktoriya Khaitova, Donald Gardenier, Michael Linderman Ponni Perumalswami, Thomas Schiano, Joseph Odin, Lawrence Liu, Douglas Dieterich, Andrea Branch. Mt Sinai Hosp. NYC
SUMMARY
· Costs were higher and SVR rates were lower than predicted based on results of randomized clinical trials
· The SVR rate was 44% on an ITT basis
· 45% of costs were spent on patients who failed to achieve SVR
· Median cost was $83,509 per patient
· Median cost was $188,859 per SVR
· TVR, peg-IFN, and RBV accounted for 61%, 24%, and 4% of total costs, respectively.
· Adverse event management accounted for 8% of costs and was primarily driven by anemia; ~50% of patients required epoeitin-α and 9% received blood transfusion
CONCLUSIONS
· Costs were higher and our 44% SVR rate was lower than predi
cted based on results of randomized clinical trials, consistent with other data
- Sethi et al. Abstract #1865 - cost per SVR was $183,428
- CUPIC, SVR = 40%
· Cost per SVR is highly sensitive to the SVR rate, some groups report a higher real world SVR rate than we do
- Di Bisceglie et al., SVR6 = 60%
· Real world data need to be included in estimates of costs and predicted benefits of current and future HCV treatment
· Clinical- and cost-effectiveness could be increased by lowering drug prices, by improving safety, and by increasing efficacy (SVR rates).
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