Cost effectiveness of interferon ?2b combined with ribavirin for the treatment of chronic hepatitis C
Open Access
- 1 November 1999
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Hepatology
- Vol. 30 (5), 1318-1324
- https://doi.org/10.1002/hep.510300518
Abstract
Treatment of chronic hepatitis C with Interferon (IFN) α2b monotherapy results in 10% to 15% sustained virological response (SVR). Combining IFN with ribavirin increases this response. In this analysis, using the Markov model, 6 treatment strategies for chronic hepatitis C (previously untreated) were compared on the basis of incremental cost per additional quality-adjusted life years ($/QALY). Our results showed that the no treatment strategy was associated with a cost of $38,747 and 13.10 QALYs. The strategy using IFN alone for 48 weeks was associated with a cost of $35,642 and 14.05 QALYs. The strategy using IFN monotherapy followed by combination therapy for nonresponders and relapsers was associated with a cost of $34,561 and 15.53 QALYs. A similar strategy, but limiting combination to relapsers only, was associated with a cost of $34,758 and 14.40 QALYs. The strategy using IFN with ribavirin as the initial therapy for all patients was associated with a cost of $34,792 and 15.31 QALYs. Finally, the strategy using viral genotyping first and then adjusting the duration of combination therapy based on genotype was associated with a cost of $37,263 and 15.89 QALYs. The strategy using genotyping to guide duration of combination therapy was the most cost-effective approach with an incremental cost-effectiveness ratio of $7,500 per QALY. Sensitivity analyses confirmed the robustness of these results. We conclude that combination of IFN and ribavirin with duration of therapy based on the viral genotype, is a cost-effective approach in treating patients with chronic hepatitis C.Keywords
This publication has 25 references indexed in Scilit:
- Morbidity and mortality in compensated cirrhosis type C: A retrospective follow-up study of 384 patientsGastroenterology, 1997
- The long-term pathological evolution of chronic hepatitis CHepatology, 1996
- Predictors of sustained response, relapse and no response in patients with chronic hepatitis C treated with interferon-αJournal of Viral Hepatitis, 1995
- Therapy of Hepatitis CSeminars in Liver Disease, 1995
- THERAPY FOR CHRONIC HEPATITIS CGastroenterology Clinics of North America, 1994
- Liver transplantation for hepatitis C virus-related cirrhosisHepatology, 1994
- AN ANALYSIS OF LIVER TRANSPLANT EXPERIENCE FROM 37 TRANSPLANT CENTERS AS REPORTED TO MEDICARETransplantation, 1993
- Risk Factors for Hepatocellular Carcinoma among Patients with Chronic Liver DiseaseNew England Journal of Medicine, 1993
- Hepatocellular Carcinoma in Italian Patients with CirrhosisNew England Journal of Medicine, 1991
- Treatment of Chronic Hepatitis C with Recombinant Interferon AlfaNew England Journal of Medicine, 1989