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Infectious Disease

Letter to the Editor

, &
Page 445 | Accepted 24 Mar 2014, Published online: 09 Apr 2014

Re: Cure S, Bianic F, Gavart S, et al. Cost-effectiveness of telaprevir in combination with pegylated interferon alpha and ribavirin in previously untreated chronic hepatitis C genotype 1 patients. J Med Econ 2014;17:65-76

And: Cure S, Bianic F, Gavart S, et al. Cost-effectiveness of telaprevir in combination with pegylated interferon alpha and ribavirin in treatment-experienced patients. J Med Econ 2014;17:77-87

Dear Editor,

We recently read with great interest two studies on the cost-effectiveness of telaprevir plus peginterferon–ribavirin in treatment-naïve and treatment-experienced patients, respectively, by Cure et al.Citation1,Citation2. Cure et al. have developed robust models, building on the well established work on cost-effectiveness in this disease area.

I find it troubling though that Cure et al. have not considered sensitivity analyses on the outcome parameter (i.e., sustained virologic response [SVR]). Cure et al. have included SVR data from a single indirect treatment comparison meta-analysisCitation3. However, several additional indirect treatment comparisons of telaprevir and boceprevir have been published in the peer-reviewed literatureCitation4–6, and it has been established that there are substantial discrepancies between these meta-analysesCitation7. Given this, it seems essential that Cure et al. should have conducted sensitivity analyses of the outcome parameter before making conclusions about the cost-effectiveness of telaprevir.

Transparency

Declaration of financial/other relationships

E.D., K.T., and E.J.M. have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article.

References

  • Cure S, Bianic F, Gavart S, et al. Cost-effectiveness of telaprevir in combination with pegylated interferon alpha and ribavirin in previously untreated chronic hepatitis C genotype 1 patients. J Med Econ 2014;17:65-76
  • Cure S, Bianic F, Gavart S, et al. Cost-effectiveness of telaprevir in combination with pegylated interferon alpha and ribavirin in treatment-experienced patients. J Med Econ 2014;17:77-87
  • Cure S, Diels J, Gavart S, et al. Efficacy of telaprevir and boceprevir in treatment-naïve and treatment experienced genotype 1 chronic hepatitis C patients: an indirect comparison using Bayesian network meta-analysis. Curr Med Res Opin 2012;28:1841-56
  • Cooper C, Lester R, Thorlund K, et al. Direct-acting antiviral therapies for hepatitis C genotype 1 infection: a multiple treatment comparison meta-analysis. QJM 2013;106:153-63
  • Cooper C, Druyts E, Thorlund K, et al. Boceprevir and telaprevir for the treatment of chronic hepatitis C genotype 1 infection: an indirect comparison meta-analysis. J Therapeut Clin Risk Manag 2012;5:105-30
  • Kieran J, Schmitz S, O’Leary A, et al. The relative efficacy of boceprevir and telaprevir in the treatment of hepatitis C virus genotype 1. Clin Infect Dis 2013;56:228-35
  • Druyts E, Thorlund K, Humphreys S, et al. Interpreting discordant indirect and multiple treatment comparison meta-analyses: an evaluation of direct acting antivirals for hepatitis C infection. Clin Epidemiol 2013;5:173-83

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