{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T15:36:26Z","timestamp":1764084986212,"version":"3.40.5"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,11,15]],"date-time":"2020-11-15T00:00:00Z","timestamp":1605398400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Current literature indicates that direct\u2010acting antivirals (DAAs) are cost\u2010effective to treat compensated cirrhotic patients with hepatitis C. Although already funded by public payers, it is unknown whether it is economical to reimburse DAAs within the more advanced decompensated cirrhosis population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A state\u2010transition model was developed to conduct a cost\u2010utility analysis of sofosbuvir\u2010velpatasvir (SOF\/VEL) plus ribavirin regimen for 12\u00a0weeks. The evaluated cohort had a mean age of 58\u00a0years and Child\u2010Turcotte\u2010Pugh (CTP) class B cirrhosis with decompensated symptoms. A scenario analysis was performed on CTP C patients. We used a payer perspective, a lifetime time horizon and a 1.5% annual discount rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>While SOF\/VEL plus ribavirin treatment for 12\u00a0weeks increased costs by $156\u00a0676, it provided an extra 4.00 quality\u2010adjusted life years (QALYs) compared to best supportive care (no DAA therapy). With an incremental cost\u2010effectiveness ratio of $39\u00a0169 per QALY, SOF\/VEL plus ribavirin was determined to be cost\u2010effective at a willingness to pay of $50\u00a0000 per QALY. SOF\/VEL reduced liver\u2010related deaths and reduced progression to CTP C cirrhosis by 20.4% and 21.9%, respectively. On the contrary, SOF\/VEL regimen resulted in increases in liver transplants and hepatocellular carcinoma (HCC) by 54.0% and 42.5%, respectively. Similar results were found for CTP C patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This analysis informs payers that SOF\/VEL should continue to be reimbursed in decompensated hepatitis C patients. It also supports the recommendations by the American Association for the Study of Liver Diseases to continue screening for HCC in decompensated cirrhotic patients who have achieved sustained virologic response.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jvh.13419","type":"journal-article","created":{"date-parts":[[2020,10,16]],"date-time":"2020-10-16T21:13:55Z","timestamp":1602882835000},"page":"260-267","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Cost\u2010effectiveness analysis of sofosbuvir and velpatasvir in chronic hepatitis C patients with decompensated cirrhosis"],"prefix":"10.1111","volume":"28","author":[{"given":"Jocelyn","family":"Chan","sequence":"first","affiliation":[{"name":"Faculty of Science School of Pharmacy University of Waterloo Kitchener ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8737-861X","authenticated-orcid":false,"given":"John J.","family":"Kim","sequence":"additional","affiliation":[{"name":"Faculty of Science School of Pharmacy University of Waterloo Kitchener ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brett K.","family":"Barrett","sequence":"additional","affiliation":[{"name":"Faculty of Science School of Pharmacy University of Waterloo Kitchener ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9419-1797","authenticated-orcid":false,"given":"Abdullah","family":"Hamadeh","sequence":"additional","affiliation":[{"name":"Faculty of Science School of Pharmacy University of Waterloo Kitchener ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan J.","family":"Feld","sequence":"additional","affiliation":[{"name":"Toronto Centre for Liver Disease University Health Network University of Toronto Toronto ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4630-0052","authenticated-orcid":false,"given":"William W.L.","family":"Wong","sequence":"additional","affiliation":[{"name":"Faculty of Science School of Pharmacy University of Waterloo Kitchener ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,11,15]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.170453"},{"key":"e_1_2_8_3_1","unstructured":"HepatitisC.Canadian Liver Foundation.https:\/\/www.liver.ca\/patients\u2010caregivers\/liver\u2010diseases\/hepatitis\u2010c\/. 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