Budget Impact Analysis of HCV Patients’ Pathway: Past, Present and Future in the Italian Landscape

Objectives: The present study aims at analysing the budget impact related to the management of patients with Hepatitis C Virus (HCV) in Italy, over the years. Indeed, despite an increasing expenditure related to the novel HCV treatments was registered, due also to an increased therapeutic strategies efficacy, little is known about the expenditure related to the overall pathway, considering the capability of the novel therapies to improve the clinical management of HCV patients. Methods: Economic evaluation considered the biennial cost of 578 HCV patients’ pathway, registered by three Hospitals in Lombardy Region (Italy), and considered the following items of healthcare expenditure: examinations, diagnostic procedures, outpatients and inpatients activities, and day-hospital events, also for the management of drug-related adverse events and complications. HCV population was stratified according to the two different waves of antiviral drugs available in the Italian market (before and after 2017, the year of the introduction and extension of new HCV treatment criteria in the Italian NHS), distinguishing also Sofosbuvir (SOF)based regimes from the others. Three scenarios were simulated and compared, assuming the Italian NHS point of view, and estimating the NHS healthcare expenditure up to three years: 1) Retrospective projection considered the cost of the pathways related to the first wave of drugs and the HCV population effectively treated in the period 2015-2017 (108.887 patients); 2) Hypothetical retrospective projection considered the cost of the pathways related to the second wave of drugs, but the HCV population effectively treated in the period 2015-2017; 3) Perspective projection: considered the cost of the pathways related to the second wave of antiviral drugs, and the forecast HCV population treated in the period 2018-2020 (172.938 patients). Results: In the comparison between the two retrospective projections, NHS total costs devoted to the treatment of HCV patients decreased of -35%: if new treatments had been available since 2015, the economic saving would have been equal to 68,696,848€ (about 630€ per treated patient). Results from perspective projection revealed that the saving were confirmed in the long term (about 500€ per treated patient equal to -28%), despite the increase in the population assuming therapeutic strategies. If the SOFbased regimens market shares increased, savings up to 13% would be registered. Conclusions: The results reported new evidence concerning the resources absorption related to HCV patients. Innovative drugs have increased the expenditure for drugs but ensuring an efficient management of the overall pathway (reduction of 63% in expenditure for hospitalizations), with a lower resource absorption per patient. Journal of Digestive Diseases and Hepatology Foglia E, et al. J Dig Dis Hepatol 6: 172. www.doi.org/10.29011/2574-3511.100072 www.gavinpublishers.com Citation: Foglia E, Garagiola E, Ferrario L, Lombardi A, Grecchi C, et al. (2022) Budget Impact Analysis of HCV Patients’ Pathway: Past, Present and Future in the Italian Landscape. J Dig Dis Hepatol 6: 172. DOI: 10.29011/2574-3511.100072 2 Volume 6; Issue 01 J Dig Dis Hepatol, an open access journal ISSN: 2574-3511