{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T03:44:06Z","timestamp":1781063046467,"version":"3.54.1"},"reference-count":58,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2016,7,1]],"date-time":"2016-07-01T00:00:00Z","timestamp":1467331200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["MDM Policy &amp; Practice"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:p> Background: Chronic hepatitis C viral (HCV) infection affects millions of Americans. Health care systems face complex choices between highly efficacious, costly treatments. This study assessed the cost-effectiveness of treatments for chronic, genotype 1 HCV monoinfected, treatment-na\u00efve individuals in the Department of Veterans Affairs (VA) and general US health care systems. Methods: The study used a decision-analytic Markov model, employing appropriate payer perspectives and time horizons, and discounting benefits and costs at 3% annually. Interventions included the following: sofosbuvir\/ledipasvir (SOF-LDV); ombitasvir\/paritaprevir\/ritonavir\/dasabuvir (3D); sofosbuvir\/simeprevir (SOF-SMV); sofosbuvir\/pegylated interferon\/ribavirin (SOF-RBV-PEG); boceprevir\/pegylated interferon\/ribavirin (BOC-RBV-PEG); and pegylated interferon\/ribavirin (PEG-RBV). Outcomes were sustained virologic response (SVR), advanced liver disease, costs, quality adjusted life years (QALYs), and incremental cost-effectiveness. Results: SOF-LDV and 3D achieve high SVR rates, reducing advanced liver disease (&gt;20% relative to no treatment), and increasing QALYs by &gt;2 years per person. For the non-VA population, at current prices ($5040 per week for SOF-LDV; $4796 per week for 3D), SOF-LDV\u2019s lifetime cost ($293,370) is $18,000 lower than 3D\u2019s because of its shorter duration in subgroups. SOF-LDV costs $17,100 per QALY gained relative to no treatment. 3D costs $208,000 per QALY gained relative to SOF-LDV. Both dominate other treatments and are even more cost-effective for the VA, though VA aggregate treatment costs still exceed $4 billion at SOF-LDV prices of $3308 per week. Drug prices strongly determine relative cost-effectiveness for SOF-LDV and 3D; with price reductions of 20% to 30% depending on health system, 3D could be cost-effective relative to SOF-LDV. We currently lack head-to-head regimen effectiveness trials. Conclusions: New HCV treatments are cost-effective in multiple health care systems if trial-estimated efficacy is achieved in practice, though, at current prices, total expenditures could present substantial challenges. <\/jats:p>","DOI":"10.1177\/2381468316671946","type":"journal-article","created":{"date-parts":[[2016,10,4]],"date-time":"2016-10-04T03:29:50Z","timestamp":1475551790000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Cost-Effectiveness of Treatments for Genotype 1 Hepatitis C Virus Infection in Non-VA and VA Populations"],"prefix":"10.1177","volume":"1","author":[{"given":"Shan","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Industrial and Systems Engineering, University of Washington, Seattle, Washington (SL)"},{"name":"VA Center for Innovation to Implementation, Menlo Park, California (PGB, RG, SMA, DKO)"},{"name":"VA Health Economics Resource Center, VA Palo Alto Health Care System, Menlo Park, California (PGB, JL, VRJ, RG)"},{"name":"Department of Health Research and Policy, Stanford University, Stanford, California (PGB)"},{"name":"AIDS Research Center, VA Palo Alto Health Care System, Menlo Park, California (MH)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul G.","family":"Barnett","sequence":"additional","affiliation":[{"name":"Department of Industrial and Systems Engineering, University of Washington, Seattle, Washington (SL)"},{"name":"VA Center for Innovation to Implementation, Menlo Park, California (PGB, RG, SMA, DKO)"},{"name":"VA Health Economics Resource Center, VA Palo Alto Health Care System, Menlo Park, California (PGB, JL, VRJ, RG)"},{"name":"Department of Health Research and Policy, Stanford University, Stanford, California (PGB)"},{"name":"AIDS Research Center, VA Palo Alto Health Care System, Menlo Park, California (MH)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Holodniy","sequence":"additional","affiliation":[{"name":"Department of Industrial and Systems Engineering, University of Washington, Seattle, Washington (SL)"},{"name":"VA Center for Innovation to Implementation, Menlo Park, California (PGB, RG, SMA, DKO)"},{"name":"VA Health Economics Resource Center, VA Palo Alto Health Care System, Menlo Park, California (PGB, JL, VRJ, RG)"},{"name":"Department of Health Research and Policy, Stanford University, Stanford, California (PGB)"},{"name":"AIDS Research Center, VA Palo Alto Health Care System, Menlo Park, California (MH)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanie","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Industrial and Systems Engineering, University of Washington, Seattle, Washington (SL)"},{"name":"VA Center for Innovation to Implementation, Menlo Park, California (PGB, RG, SMA, DKO)"},{"name":"VA Health Economics Resource Center, VA Palo Alto Health Care System, Menlo Park, California (PGB, JL, VRJ, RG)"},{"name":"Department of Health Research and Policy, Stanford University, Stanford, California (PGB)"},{"name":"AIDS Research Center, VA Palo Alto Health Care System, Menlo Park, California (MH)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vilija R.","family":"Joyce","sequence":"additional","affiliation":[{"name":"Department of Industrial and Systems Engineering, University of Washington, Seattle, Washington (SL)"},{"name":"VA Center for Innovation to Implementation, Menlo Park, California (PGB, RG, SMA, DKO)"},{"name":"VA Health Economics Resource Center, VA Palo Alto Health Care System, Menlo Park, California (PGB, JL, VRJ, RG)"},{"name":"Department of Health Research and Policy, Stanford University, Stanford, California (PGB)"},{"name":"AIDS Research Center, VA Palo Alto Health Care System, Menlo Park, California (MH)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Risha","family":"Gidwani","sequence":"additional","affiliation":[{"name":"Department of Industrial and Systems Engineering, University of Washington, Seattle, Washington (SL)"},{"name":"VA Center for Innovation to Implementation, Menlo Park, California (PGB, RG, SMA, DKO)"},{"name":"VA Health Economics Resource Center, VA Palo Alto Health Care System, Menlo Park, California (PGB, JL, VRJ, RG)"},{"name":"Department of Health Research and Policy, Stanford University, Stanford, California (PGB)"},{"name":"AIDS Research Center, VA Palo Alto Health Care System, Menlo Park, California (MH)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven M.","family":"Asch","sequence":"additional","affiliation":[{"name":"Department of Industrial and Systems Engineering, University of Washington, Seattle, Washington (SL)"},{"name":"VA Center for Innovation to Implementation, Menlo Park, California (PGB, RG, SMA, 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