Fig 1.
State-transition model schematic of showing the natural history of hepatitis C virus infection.
Abbreviations: DC = decompensated cirrhosis; HCC = hepatocellular carcinoma; HCV = hepatitis C virus; LRD = liver-related death; SVR = sustained virologic response. (Adapted from Chhatwal et al.[9])
Table 1.
Annual transition probabilities, healthcare costs and quality of life weights for different Markov states.
Table 2.
Cost-effectiveness results comparing model outcomes of no treatment versus treatment with direct-acting antivirals in India.
Table 3.
Disability-adjusted life years (DALYs) averted with DAA-based treatment in HCV-infected patients in India, in relation to presence or absence of cirrhosis and viral genotype.
Fig 2.
Change in adverse clinical outcomes in patients with hepatitis C virus infection in India following treatment using regimens based on directly-acting antiviral drugs available there at low cost.
Abbreviations: DAA, direct-acting antivirals; DC, decompensated cirrhosis; HCC, hepatocellular carcinoma; LRD, liver-related deaths.
Fig 3.
Cost-effectiveness of directly-acting antiviral drug-based treatment of persons with hepatitis C virus infection at various stages of liver fibrosis in India, depending on modelling time horizon.
Fig 4.
Cost-effectiveness of direct-acting antiviral drug-based treatment of persons with hepatitis C virus infection, by age of starting treatment (years) and time horizon.
DAAs became cost-effective within 2 years of initiation of treatment irrespective of patient’s age; and DAAs became cost-saving for patients of age ≤50 around 10 years but never for patients at the age ≥60.
Fig 5.
Tornado diagram for one-way sensitivity analysis of incremental cost-effectiveness ratio using (A) $ per additional quality-adjusted life-year, and (B) $ per disability-adjusted life-year averted.
Horizontal bars show the variation in incremental cost-effectiveness ratio (ICER; in $/QALY gained or $/DALY averted) with variation in the value of the parameter. In the parameter names, the prefix ‘c’ represents cost of a health-state, ‘q’ the quality-of-life weight and ‘p’ the transition probability from one state to the other. Values of ICER below 0 indicate that the treatment is cost-saving. Abbreviations: QALY = quality-adjusted life-year, DALY = disability-adjusted life-year.
Table 4.
Sensitivity analyses of cost-effectiveness results by age at time of treatment, cost of anti-HCV drug therapy and annual discount rate.