{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T13:02:48Z","timestamp":1792587768602,"version":"4.5.0"},"reference-count":64,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,12,1]],"date-time":"2016-12-01T00:00:00Z","timestamp":1480550400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004334","name":"Merck","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004334","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2017,2]]},"abstract":"Summary<\/jats:title>Background<\/jats:title>The presence of baseline NS<\/jats:styled-content>5A resistance\u2010associated variants (RAV<\/jats:styled-content>s) impacted treatment response in HCV<\/jats:styled-content> genotype 1a (GT<\/jats:styled-content>1a)\u2010infected patients treated with elbasvir\/grazoprevir (EBR<\/jats:styled-content>\/GZR<\/jats:styled-content>) for 12 weeks, but not patients treated with EBR<\/jats:styled-content>\/GZR<\/jats:styled-content> and ribavirin (RBV<\/jats:styled-content>) for 16 weeks.<\/jats:p><\/jats:sec>Aims<\/jats:title>To assess the cost\u2010effectiveness of baseline testing for NS<\/jats:styled-content>5A RAV<\/jats:styled-content>s in EBR<\/jats:styled-content>\/GZR<\/jats:styled-content>\u2010treated patients compared without testing, and with current treatments for GT<\/jats:styled-content>1a patients.<\/jats:p><\/jats:sec>Methods<\/jats:title>We simulated the course of treatment with EBR<\/jats:styled-content>\/GZR<\/jats:styled-content>, ledipasvir\/sofosbuvir (LDV<\/jats:styled-content>\/SOF<\/jats:styled-content>) and ombitasvir\/paritaprevir\/ritonavir+dasabuvir (3D) with or without RBV<\/jats:styled-content> and natural history of disease of GT<\/jats:styled-content>1a patients. Treatment\u2010related data from clinical trials were used in a state\u2010transition model of the natural history of chronic HCV GT<\/jats:styled-content>1a infection and liver disease to project lifetime costs (US<\/jats:styled-content>$2015) and quality\u2010adjusted life years (QALY<\/jats:styled-content>). Other clinical and economic inputs were estimated from published sources. We conducted base case and sensitivity analyses.<\/jats:p><\/jats:sec>Results<\/jats:title>RAV<\/jats:styled-content>s testing\u2010guided treatment with EBR<\/jats:styled-content>\/GZR<\/jats:styled-content> resulted in more QALY<\/jats:styled-content>s than EBR<\/jats:styled-content>\/GZR<\/jats:styled-content> without testing, 3D+RBV<\/jats:styled-content>, or LDV<\/jats:styled-content>\/SOF<\/jats:styled-content>8. This strategy was cost\u2010saving relative to 3D+RBV<\/jats:styled-content> or LDV<\/jats:styled-content>\/SOF<\/jats:styled-content>8 and was cost\u2010effective compared with EBR<\/jats:styled-content>\/GZR<\/jats:styled-content> without testing. LDV<\/jats:styled-content>\/SOF<\/jats:styled-content>12 was not cost\u2010effective compared with the EBR<\/jats:styled-content>\/GZR RAV<\/jats:styled-content>s testing\u2010based strategy. Treatment with EBR<\/jats:styled-content>\/GZR<\/jats:styled-content> guided by RAV<\/jats:styled-content>s testing is the most effective regimen among treatment\u2010experienced patients without cirrhosis and cirrhotic patients. In sensitivity analysis, RAV<\/jats:styled-content>s testing was cost\u2010effective in 48\u201355% and 63\u201385% among noncirrhotic and cirrhotic patients respectively.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>RAV<\/jats:styled-content>s testing before treatment with EBR<\/jats:styled-content>\/GZR<\/jats:styled-content> is likely to be a cost\u2010effective alternative to the use of EBR<\/jats:styled-content>\/GZR<\/jats:styled-content> without testing, LDV<\/jats:styled-content>\/SOF<\/jats:styled-content>, or 3D among GT<\/jats:styled-content>1a treatment\u2010na\u00efve or treatment\u2010experienced patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.13882","type":"journal-article","created":{"date-parts":[[2016,12,2]],"date-time":"2016-12-02T01:57:03Z","timestamp":1480643823000},"page":"455-467","source":"Crossref","is-referenced-by-count":19,"title":["The cost\u2010effectiveness of testing for NS<\/scp>5a resistance\u2010associated polymorphisms at baseline in genotype 1a\u2010infected (treatment\u2010na\u00efve and treatment\u2010experienced) subjects treated with all\u2010oral elbasvir\/grazoprevir regimens in the United States"],"prefix":"10.1111","volume":"45","author":[{"given":"E. 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