PIN50 Choice of Recommended Treatment Options for Patients with Hepatitis C Genotypes 2 and 3 in Moscow, Russian Federation

The possibilities of modern therapy for chronic hepatitis C include a large number of options that have marked differences in both effectiveness and cost. The aim of this study was to select optimal treatment regimens for chronic hepatitis C virus (HCV) genotype 1 for reimbursement in Moscow in 2020 based on their comparative efficacy and costs per course. Treatment regimens were ranked based on their comparative efficacy and costs per course. Comparative efficacy was evaluated based on published network meta-analyses, as well as our own indirect comparisons. Prices for drugs were provided by the Moscow Healthcare Department. When determining the target sub-groups of patients, the virus genotype, the presence or absence of treatment experience and liver cirrhosis were taken into account. List of comparators included pangenotypic and non-pangenotypic regimens, with the exception of regimens containing peginterferons. Based on the results of the analysis, several recommended schemes were selected for each of the target groups. Multilple regimens were recommended due to the fact that the cost of the course of treatment and the efficacy of all top regimens were comparable. In genotype 1a patients independent of subgroups top-3 regimens were: daclatasvir+sofosbuvir±ribavirin (€ 5938 per course), grasoprevir+elbasvir (€ 5964) and velpatasvir+sofosbuvir (€ 6223). The 4th and 5th positions in treatment-naïve and experienced patients without cirrhosis was dasabuvir+ombitasvir+paritaprevir+ritonavir+ribavirin (€ 6237) and glecaprevir+pibrentasvir (€ 6333). The 4th regimen for treatment-naïve cirrhotic patients was glecaprevir+pibrentasvir (€ 6333). In genotype 1b patients independent of subgroups top-4 regimens were: daclatasvir+sofosbuvir±ribavirin (€ 5938), grasoprevir+elbasvir (€ 5964), dasabuvir+ombitasvir+paritaprevir+ritonavir (€ 6219) and velpatasvir+sofosbuvir (€6223). The 5th regimen for all target groups, except treatment-experienced cirrhotic patients was glecaprevir+pibrentasvir (€ 6333). As a result of a transparent and scientific-based analysis were selected treatment regimens for patients with chronic HCV genotype 1 recommended for reimbursement in Moscow in 2020.