He T, et al. – This systematic review was performed to examine published studies evaluating the cost–effectiveness of direct–acting antivirals (DAAs) for hepatitis C virus (HCV) genotype 2–6 infections, and synthesise and re–evaluate results with updated drug prices. In patients with HCV genotypes 2–5, HCV treatment with DAAs was highly cost–effective at a $100 000/quality–adjusted life–years (QALYs) threshold. From both a public health and economic perspective, timely HCV treatment would be an optimal strategy.

• For this study, the researchers performed a systematic search of various electronic databases, including Medline, EMBASE, Cochrane library and EconLit for cost-effectiveness studies published from 2011 to 2016.
• They included studies evaluating DAAs for genotypes 2-6.
• They abstracted reported costs, quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs).
• They re-estimated ICERs by varying the price of DAAs from $20 000 to $100 000, and estimated the threshold price at which DAA regimens would be deemed cost-effective (ICER≤$100 000/QALY).

• The researchers included 92 ICERs for 7 different DAA regimens from 10 published articles.
• 20 were for genotype 2, 40 for genotype 3, 30 for genotype 4, 2 for genotype 5 and none for genotype 6 among the abstracted 92 ICERs; thus, only genotypes 2-5 were examined.
• 87.0% analyses found DAA regiments to be cost-effective, and 7.6% found to be cost-saving at the discounted price of $40 000.
• As per the outcomes, the median threshold price below which DAAs would be deemed cost-effective was between $144 400 and $225 000, and cost-saving between $17 300 and $25 400.