Estimating the Long-Term Clinical and Economic Outcomes of Daclatasvir Plus Asunaprevir in Difficult-to-Treat Japanese Patients Chronically Infected with Hepatitis C Genotype 1b

Objectives: Japan has one of the highest endemic rates of hepatitis C virus (HCV) infection. Treatments in Japan are currently limited to interferon-alfa–based regimens, which are associated with tolerability and efficacy issues. A novel regimen combining two oral HCV therapies, daclatasvir and asunaprevir (DCV þ ASV), has shown favorable results in Japanese patients with chronic genotype 1b HCV infection. Comparisons of clinical and economic outcomes associated with DCV þ ASV treatment and current standards of care were investigated. Methods: The MOdelling the NAtural histoRy and Cost-effectiveness of Hepatitis cost-effectiveness model projected outcomes in 1000 patients aged 70 years with either chronic hepatitis C or compensated cirrhosis over a lifetime simulation. Japanesespecific disease transition rates were used, and discounting was applied annually at a rate of 2%. Efficacy data for DCV þ ASV and telaprevir triple therapy (telaprevir þ pegylated interferon-alfa þ ribavirin [TVR þ pegIFN-α/RBV]) were obtained from a Japanese subgroup analysis found within a global meta-analysis: sustained virological response rates of 74%, 85%, and 87% were reported for null responders (NRs), partial responders (PRs), and interferon-alfa–ineligible/intolerant patients, respectively, treated with DCV þ ASV, and rates of 42% and 59% were reported for NRs and PRs, respectively, ee front matter Copyright & 2014, International S