Conference on Retroviruses and Opportunistic Infections (CROI)

Conference on Retroviruses and Opportunistic Infections (CROI)

March 02, 2015
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Average cost per SVR12 was $171,000 for Olysio, Sovaldi regimens

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SEATTLE — The mean cost per sustained virologic response at 12 weeks among a cohort of patients with hepatitis C virus infection receiving treatment with Olysio and Sovaldi with or without ribavirin, was approximately $171,000, according to data presented at CROI 2015.

“The aim of this study was to estimate the cost per [sustained virologic response] of [simeprevir and sofosbuvir with or without ribavirin] in patients chronically infected with genotype 1 hepatitis C in a real-world setting,” Kian Bichoupan, PhD, of Icahn School of Medicine at Mount Sinai, said during his presentation at CROI.

Bichoupan and colleagues gathered data from 202 patients with HCV who were being seen by Mount Sinai providers between December 2013 and June 2014 and receiving treatment with Olysio (simeprevir, Janssen Therapeutics) and Sovaldi (sofosbuvir, Gilead Sciences) with or without ribavirin. Of these patients, 170 completed treatment and were compared with a cohort of 224 patients who received Incivek (telaprevir, Vertex) or Victrelis (boceprevir, Merck) plus pegylated interferon and ribavirin treated at Mount Sinai between 2011 and 2012. In total, 173  patients were included in the cost analysis on a per-protocol basis, Bichoupan said during his presentation. 

Costs of regimens were calculated using data from Medicare, Agency for Healthcare Research and Quality, Red Book Wholesale Acquisition Costs and the number of days on treatment, according to the presentation.

Overall, 88% of all the patients (n=153) achieved SVR at 12 weeks; 89% of patients in the simeprevir and sofosbuvir group (72/81) and 88% in the simeprevir, sofosbuvir and ribavirin group (81/92), according to the presentation.

The overall total cost for the regimen among this cohort was $26,185,256, with the total mean cost of SVR12 being $171,145, according to Bichoupan. Overall SVR12 costs were more among the patients who received simeprevir, sofosbuvir and ribavirin vs. patients who received simeprevir and sofosbuvir ($172,776 vs. $169,311), but were not incredibly different, according to Bichoupan.   

“Eleven percent of all costs were accounted for patients who failed therapy,” Bichoupan said.

Sensitivity analysis showed that after applying a discount of up to 50% for HCV pharmaceuticals, the cost for SVR decreased to $86,547, according to Bichoupan.

Prior treatment with telaprevir or boceprevir costs for SVR was $200,000 and the SVR rate was lower at 76% compared with the cohort treated with simeprevir and sofosbuvir, according to the presentation.

Serious adverse events, such as hospitalization for variceal bleeding or acute kidney failure and infection, were observed in six patients, five of which received simeprevir and sofosbuvir only. The total cost of adverse event management was $59,127.

“Prior use of telaprevir and boceprevir leading to a failure was independently associated with a decreased likelihood of SVR,” Bichoupan concluded. “The mean cost of SVR was $171,000 and was sensitive to discount rates on drug costs.” – by Melinda Stevens

Reference:

Bichoupan K, et al. Abstract 149.  Presented at: Conference on Retroviruses and Opportunistic Infections; Feb. 23-26, 2015; Seattle.

Disclosure: The study was funded by Janssen. Bichoupan reports serving as a consultant for Janssen.