Grieve, Richard, Roberts, Jennifer, Wright, Mark, Sweeting, Michael, DeAngelis, Daniela, Rosenberg, William, Bassendine, Margaret, Main, Janice and Thomas, Howard
Cost-effectiveness of interferon ? or peginterferon ?, with ribavirin for histologically mild chronic hepatitis C
Gut, 55, (9), . (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 ? or peginterferon ? 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 ??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 ??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.
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