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SOF/SMV 12w more cost-effective than SOF/RBV 24w GT1 ineligible/intolerant

Cost analysis of sofosbuvir/ribavirin versus sofosbuvir/simeprevir for genotype 1 HCV in interferon ineligible/intolerant individuals

http://onlinelibrary.wiley.com/doi/10.1002/hep.27151/abstract

A 24-week course of SOF/RBV costs approximately US$169,000, with sustained virologic response (SVR) rates ranging from 52-84%; 12 weeks of SOF/SMV costs approximately $150,000, with SVR between 89% and 100%. Because SOF/SMV is currently used off-label, debate exists among physicians and payers about whether it should be prescribed and covered. This paper presents a cost-effectiveness analysis of these two treatment regimens accounting for costs of drugs, treatment-related medical care, re-treatment for individuals who do not achieve SVR, and natural history of continued HCV infection after failed re-treatment. - :

Conclusions: These results suggest that a 12-week course of SOF/SMV is a more cost-effective treatment for genotype 1 CHC than 24 weeks of SOF/RBV among interferon-ineligible/intolerant individuals, supporting the AASLD/IDSA guidance and offering implications for both clinical and regulatory decision-making as well as pharmaceutical pricing. (Hepatology 2014;) -

Publication History
Accepted manuscript online: 28 MAR 2014 12:31AM EST
Manuscript Accepted: 25 MAR 2014
Manuscript Revised: 17 MAR 2014
Manuscript Received: 26 FEB 2014

Further proof to submit if needed with Off-Label request.
7 Responses
Avatar universal
Hi Jimmy....thanks! I've maintained that there was a cost savings but it's nice to have the exact amount in print. I'll add it to my arsenal in support of requesting the off label script and pass it on.

Took my 8th dose of Sovaldi/Olysio last night...76 to go. No sx and I feel 'different', like something is missing. Even if it's mind over matter, I'll take it! :)

Hope you're doing well. You do an amazing job with research and support here.
Avatar universal
Glad you are started on these meds. You are going to be VERY impressed with your first lab work.  I am going on four weeks and while still have  headaches and some insomnia, the meds are definitely working.  My insomnia is not new and related to neuropathy. I try to convince myself the headaches are a result of the meds working,  and will cause the brain fog to lift.

Got the first of my 4 week results back and my platelet count is rising,,,,a great sign.  My ALT and AST are in normal ranges.  Hoping the VL is UND when it comes back but won't be disappointed if not.  These labs were done 4 days prior to the fourth week as I have a Dr's appointment.

Maybe I should call my wife PamelaJean2 as that is her name :)  So  thankful people finally have real hope of being cured without having to go thru the hell of Interferon/riba.  Good luck, and keep us posted on your results.  Thanks to you and Jimmy for sharing your knowledge, experience, and insight.
Avatar universal
Thank you,  grouper for your kind words. From you, I take that as the highest compliment. I'm quite new to the world of heppers and my respect for all that have gone thru the hell of tx and symptoms for decades is almost inconceivable. After all the research I've done for myself, I feel obligated to share. We're in that interim period where so many...doc, insurance and patient....need educating. The landscape is changing so fast it's hard for any one person to keep up. I just want to do my small part.

So how did you get so lucky to land a Pamela Jean??? Lol...just kidding!

I started having headaches...dull throbbing at temples...and itching a couple of weeks before tx. Fatigue and insomnia have been my biggest challenges since dx last September. So I'm trying not to confuse sx from HCV and cirrhosis with tx. I do think some heacache can be attributed to tx but last couple of days I've taken small amounts of OTC and it has helped.

First labs at 2 weeks then VL at 4...will be sure to share and I'll be cheering you on as we race to the finish line of being CURED! :)
Avatar universal
Thank you.  Scheduled to start SOV/RBV 12w next week if VA pharmacy gives the ok.  (GT2)

I use google search tools to adjust time period and/or advance search for better results depending on my objective.

BTW  I use it occasionally for our community in this manner but feel free to use others ways that may be better for you.  
Advance search page text boxes .
site or domain:medhelp.org  
this exact word or phrase: Hepatitis C Community
all these words: key words
then on results page you can adjust time period using search tools  

Tip: If you start by google searching medhelp.org. Then go to advance search, medhelp org will appear in this exact word or phrase text box without the dot. If you just cut and paste it into site or domain text box be sure to put the dot back in without a space

Avatar universal
Thanks jimmy! I'm a research nut but have not tried what you suggested..great info!

Best of luck with your tx! I'll be cheering you on to the finish line of being CURED.
Avatar universal
Pamelajean, I couldn't believe when I saw this name on the forum.  Had to call my wife to look so she didn't think I was bs'n her.  I am really blessed to have my Pamela Jean.  She is a great wife, hard worker, and is an excellent mother to our children (now adults).  She has put up with my fatigue, brain fog, and nonsense :) for a lot of years. These new meds have given hope to so many.  It's a great day.
Avatar universal
I resemble that description! Lol...all kidding aside it's heartwarming to see a man describe his wife in those terms. I know because of how it makes me feel when I hear my hubby say pretty much the same.
I'd say one thing your Pamela Jean and I have in common is our taste and judgement in our husbands. :)
It is a great day and going to be a great year as we beat this thing and can get back to truly enjoying our life! And our spouses!
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