Cost and cost-effectiveness of a real-world HCV treatment program among HIV-infected individuals in Myanmar

Introduction Over half of those hepatitis C virus (HCV)/HIV coinfected live in low-income and middle-income countries, many remain undiagnosed or untreated. In 2016, Médecins Sans Frontières (MSF) established a direct-acting antiviral (DAA) treatment programme for people HCV/HIV Myanmar. The purpose our study was to evaluate the real-world cost cost-effectiveness this programme, potential if implemented by Ministry Health (MoH). Methods Costs (patient-level microcosting) outcomes were collected from MSF prospective cohort Dawei, A Markov model used assess compared with no HCV health provider perspective. Estimated lifetime healthcare costs (in 2017 US$) disability-adjusted life-years (DALYs)) simulated calculate incremental ratio (ICER), willingness-to-pay threshold per capita Gross Domestic Product Myanmar ($1250). We evaluated updated quality-assured generic DAA prices proposed simplified protocol MoH. Results From November 2016 October 2017, 122 HIV/HCV-coinfected patients treated DAAs (46% cirrhosis), 96% (n=117) achieved sustained virological response. Mean $1229 (without cirrhosis) $1971 (with drugs being largest contributor cost. Compared treatment, program cost-effective (ICER $634/DALY averted); more so $488/DALY averted). delivered MoH could be associated similar $316/DALY Conclusions Using data, among HIV-coinfected individuals is Myanmar, even prices. enhance further rollout demonstrates it not worse outcomes.