Author(s)

Mary Geitona^1*, Hara Kousoulakou¹, Ioannis Goulis², Spilios Manolakopoulos³, Themistoclis Vasiliadis², Dimitrios Christodoulou⁴, Charalabos Gogos⁵, Spyridon Dourakis³, Ioannis George Koskinas³, Alexandra Papadokostopoulou⁶, Aris Lathouris⁶, George Papatheodoridis³

¹University of Peloponnese, Corinth, Greece.
²Aristotle University of Thessaloniki, Thessaloniki, Greece.
³National and Kapodistrian University of Athens, Athens, Greece.
⁴University of Ioannina, Ioannina, Greece.
⁵University of Patras, Patra, Greece.
⁶Janssen-Cilag Pharmaceutical SACI, Athens, Greece.

Objectives: To identify local resource use such as pharmaceutical treatment, medical follow-up, and patient hospitalization and estimate the budget impact of simeprevir (SMV) plus pegylated interferon (P)/ribavirin (R) as a treatment option in the early stages of the disease in Greece. Methods: A budget impact tool was developed with a two-year time horizon, which estimated the impact on the Social Insurance Funds (SIFs) of introducing SMV + PR in the management of the early disease stages. Total direct and indirect costs were estimated for each of the following health states: non-cirrhotic chronic Hepatitis C (and within that by fibrosis stage), compensated cirrhosis, decompensated cirrhosis, and hepatocellular carcinoma. Data gaps on treatment algorithms, resource use and productivity losses were covered via an expert panel of eight leading hepatologists. Epidemiology data were taken from the published literature. Unit costs were obtained from the Ministry of Health and SIFs. The perspective was that of the SIF and the cost base year was 2015. Results: The total (direct and indirect) cost per patient per year (excluding cost of antiviral treatment) was estimated at €647, €703, €5,753, €16,313 and €37,237 for non-cirrhotic CHC, compensated cirrhosis, decompensated cirrhosis, HCC and liver transplantation, respectively. The budget impact analysis showed that adding SMV to PR in the early stages of the disease would lead to an increase in the cost of antiviral treatment by €2.03 million. Conclusions: Costs of managing CHC increase dramatically with disease severity. SMV + PR for naive patients at early disease stages has a significant but manageable budget impact, and could prevent high costs in advanced stages.

Hepatitis C, Budget Impact Analysis, Simeprevir, Greece

Geitona, M. , Kousoulakou, H. , Goulis, I. , Manolakopoulos, S. , Vasiliadis, T. , Christodoulou, D. , Gogos, C. , Dourakis, S. , George Koskinas, I. , Papadokostopoulou, A. , Lathouris, A. and Papatheodoridis, G. (2017) Managing Hepatitis C Patients in Greece: A Budget Impact Analysis of Simeprevir plus Pegylated Interferon/Ribavirin Regimen at Early Stages of the Disease. Health, 9, 1482-1493. doi: 10.4236/health.2017.911109.