Cost-effectiveness of interferon α or peginterferon α, with ribavirin for histologically mild chronic hepatitis C
Grieve, Richard, Roberts, Jennifer, Wright, Mark, Sweeting, Michael, DeAngelis, Daniela, Rosenberg, William, Bassendine, Margaret, Main, Janice and Thomas, Howard (2006) Cost-effectiveness of interferon α or peginterferon α, with ribavirin for histologically mild chronic hepatitis C. Gut, 55, (9), 1332-1338. (doi:10.1136/gut.2005.064774).
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Background: For patients with mild chronic hepatitis C the cost-effectiveness of antiviral therapy is unknown.
Aims: To assess whether anti-viral therapy (either interferon α or peginterferon α combined with ribavirin) is cost-effective at a mild stage compared to waiting and only treating those cases whoprogress to moderate disease.
Patients: Cases with mild chronic hepatitis C.
Methods: A cost-effectiveness model estimates long-term costs and outcomes for patients with mild chronic hepatitis C. The model uses effectiveness and cost data from the UK mild hepatitis C RCT, combined with estimates of disease progression and cost from observational studies.
Results: Antiviral treatment at a mild rather than a moderate stage improved outcomes measured by Quality Adjusted Life Years (QALYs) gained. The mean cost per QALY gained from
antiviral treatment with interferon α−2b and ribavirin, compared to no treatment at a mild stage, was £4,535 ($7,108) for patients with genotype non-1 and £25,188 ($39,480) for patients with
genotype 1. Providing peginterferon α−2b and ribavirin at a mild rather than a moderate stage was also associated with a gain in QALYs; the costs per QALY gained were £7,821 ($12,259)
for patients with genotype non-1 and £28,409 ($44,528) for patients with genotype 1.
Conclusions: For patients with chronic hepatitis C, it is generally more cost-effective to provide antiviral treatment at a mild rather than a moderate disease stage. For older patients (aged 65 or over) with genotype 1, antiviral treatment at a mild stage is not cost-effective.
|Keywords:||cost-effectiveness model, cost analysis, antiviral therapy|
|Subjects:||Q Science > QR Microbiology > QR355 Virology
R Medicine > RM Therapeutics. Pharmacology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
|Divisions:||University Structure - Pre August 2011 > School of Medicine > Infection, Inflammation and Repair
|Date Deposited:||25 Apr 2006|
|Last Modified:||27 Mar 2014 18:15|
|RDF:||RDF+N-Triples, RDF+N3, RDF+XML, Browse.|
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