Zepatier Less Costly, More Effective Than Harvoni, Epclusa for Hepatitis C

According to recent research presented at AMCP Nexus 2016, hepatitis C genotype 1 treatment with Zepatier (elbasvir/grazoprevir; Merck) was more effective and less expensive when compared to Harvoni (ledipasvir/sofosbuvir; Gilead) and Epclusa  (sofosbuvir/velpatasvir; Gilead). 

“An estimated 2.7 million patients are infected with chronic hepatitis C virus in the United States,” Shelby Corman, PharmD, MS, associate director of health economics and outcomes research at Pharmerit International, and colleagues said in their presentation. “Compared with interferon and ribavirin-based regimens, direct-acting antivirals have shorter treatment durations, greater efficacy, and fewer adverse events. As new direct-acting antivirals are introduced to the market, cost-effectiveness analyses are needed in order to identify the most efficient use of resources.”

In order to evaluate the efficacy of elbasvir/grazoprevir compared with ledipasvir/sofosbuvir and sofosbuvir/velpatasvir, the researchers used statistical analysis to compare the drugs over a patient’s lifetime from the perspective of a payer. They studied a population of patients infected with chronic hepatitis virus genotype 1a or 1b. Published sources and clinical trial data were used to determine the proportion of patients who achieved virologic response or discontinued therapy early. 

The researchers found that lifetime elbasvir/grazoprevir regimens were less expensive and added more quality-adjusted life years in all patient populations regardless of subtype, treatment history, or the presence of cirrhosis, when compared to ledipasvir/sofosbuvir regimens. 

Study results also showed that elbasvir/grazoprevir regimens were less expensive than sofosbuvir/velpatasvir; however, elbasvir/grazoprevir produced fewer quality-adjusted life years among patients with genotype 1a cirrhosis or patients with genotype 1b treatment naive without cirrhosis. Although, the researchers discovered in one-way sensitive analysis that when sustained virologic response was increased within sensitivity ranges, elbasvir/grazoprevir was more cost-effective. 

This study was funded by Merck & Co. —David Costill