Health policy model: long-term predictive results associated with the management of hepatitis C virus-induced diseases in Italy

Francesco Saverio Mennini,1,2 Andrea Marcellusi,1,3 Massimo Andreoni,4 Antonio Gasbarrini,5 Salvatore Salomone,6 Antonio Craxì71Centre for Economic and International Studies (CEIS) – Economic Evaluation and HTA (EEHTA) Faculty of Economics, University of Rome Tor Vergata, Rome, Italy; 2Institute of Leadership and Management in Health, Kingston University, London, UK; 3Department of Demography, University of Rome La Sapienza, Rome, Italy; 4Department of Public Health and Cell Biology, School of Medicine, University of Rome Tor Vergata, Rome, Italy; 5Gastroenterology Division, Catholic University of the Sacred Heart of Rome, School of Medicine, Rome, Italy; 6Department of Clinical and Molecular Biomedicine, Section of Pharmacology and Biochemistry, University of Catania, Catania, Italy; 7Gastroenterology Division, University of Palermo, Palermo, ItalyBackground: At present, there are no specific nationwide epidemiological studies representing the whole Italian population. This study is aimed at describing the epidemiological and economic burden that HCV will generate in the next few years in Italy. Furthermore, the impact that future anti-HCV treatments may have on the burden of disease was considered. This analysis was developed for the period 2012–2030 from the perspective of the Italian National Health Service (NHS). Methods: A published system dynamic model was adapted for Italy in order to quantify the HCV-infected population in terms of disease progression and the associated costs from 1950 to 2030. The model structure was based on transition probabilities reflecting the natural history of the disease. In order to estimate the efficacy of current anti-HCV treatment strategies for genotypes 1 and 4, the sustained virological response (SVR) rate in registration clinical trials for both boceprevir and telaprevir was estimated. It was assumed that the efficacy for patients treated with peginterferon + ribavirin was equal to the placebo arm of a randomized clinical trial (RCT) relating to boceprevir and ...