The University of Southampton
University of Southampton Institutional Repository
Warning ePrints Soton is experiencing an issue with some file downloads not being available. We are working hard to fix this. Please bear with us.

Clinical- and cost-effectiveness of pegylated interferon alfa in the treatment of chronic hepatitis C: A systematic review and economic evaluation

Clinical- and cost-effectiveness of pegylated interferon alfa in the treatment of chronic hepatitis C: A systematic review and economic evaluation
Clinical- and cost-effectiveness of pegylated interferon alfa in the treatment of chronic hepatitis C: A systematic review and economic evaluation
Objectives: To assess the clinical-effectiveness and cost-effectiveness of pegylated interferon alfa (2a and 2b) combined with ribavirin in previously untreated patients with moderate to severe chronic hepatitis C, compared with the current standard treatment, which is nonpegylated interferon alfa combined with ribavirin.
Methods: Systematic review and economic evaluation. A sensitive search strategy was applied to several electronic bibliographic databases. Relevant studies were critically appraised and meta-analyzed. A hypothetical cohort of 1,000 patients entered a Markov model and were followed up for a more than 30-year period to predict natural history, duration spent in each health state, and treatment costs.
Results: Two fully published Phase III randomized controlled trials were included. Methodological quality was generally good. Dual therapy with pegylated interferon was significantly more effective than nonpegylated dual therapy with a pooled sustained virological response rate (SVR) of 55 percent (95 percent confidence interval [CI], 52–58 percent) compared with 46 percent (95 percent CI, 43–49 percent). The pooled relative risk of remaining infected was 0.83 (95 percent CI, 0.76–0.91 percent). Genotype was the strongest predictor of outcome, with SVRs in patients with the more responsive genotypes 2 and 3 reaching up to 80 percent. The incremental cost per quality-adjusted life year (QALY) for pegylated dual therapy compared with nonpegylated dual therapy was £12,123. The cost per QALY remained under £30,000 for most patient subgroups and in sensitivity analyses.
Conclusions: Pegylated interferon is clinically effective, represents good value for the money, and is a significant advance in the treatment of this insidious disease.
randomized controlled trials, systematic review, methods, trial, databases, treatment, hepatitis C, chronic, interferons, meta-analysis, quality-adjusted life years
0266-4623
47-54
Shepherd, Jonathan
dfbca97a-9307-4eee-bdf7-e27bcb02bc67
Brodin, Håkan F.T.
2d7a47cd-9fb9-4616-b69a-3177ec0acf42
Cave, Carolyn Backer
3f76c6f5-6eaa-49d3-ae7f-f4f7fe2a6173
Waugh, Norman R.
e071ee8e-dcc4-4ba8-969e-0981bc964ad0
Price, Alison
43084e97-b383-4dd5-9ae9-df4fc8626e99
Gabbay, John
d779b76c-febe-461b-b3bb-e110163f114a
Shepherd, Jonathan
dfbca97a-9307-4eee-bdf7-e27bcb02bc67
Brodin, Håkan F.T.
2d7a47cd-9fb9-4616-b69a-3177ec0acf42
Cave, Carolyn Backer
3f76c6f5-6eaa-49d3-ae7f-f4f7fe2a6173
Waugh, Norman R.
e071ee8e-dcc4-4ba8-969e-0981bc964ad0
Price, Alison
43084e97-b383-4dd5-9ae9-df4fc8626e99
Gabbay, John
d779b76c-febe-461b-b3bb-e110163f114a

Shepherd, Jonathan, Brodin, Håkan F.T., Cave, Carolyn Backer, Waugh, Norman R., Price, Alison and Gabbay, John (2005) Clinical- and cost-effectiveness of pegylated interferon alfa in the treatment of chronic hepatitis C: A systematic review and economic evaluation. International Journal of Technology Assessment in Health Care, 21 (1), 47-54. (doi:10.1017/S0266462305050063).

Record type: Article

Abstract

Objectives: To assess the clinical-effectiveness and cost-effectiveness of pegylated interferon alfa (2a and 2b) combined with ribavirin in previously untreated patients with moderate to severe chronic hepatitis C, compared with the current standard treatment, which is nonpegylated interferon alfa combined with ribavirin.
Methods: Systematic review and economic evaluation. A sensitive search strategy was applied to several electronic bibliographic databases. Relevant studies were critically appraised and meta-analyzed. A hypothetical cohort of 1,000 patients entered a Markov model and were followed up for a more than 30-year period to predict natural history, duration spent in each health state, and treatment costs.
Results: Two fully published Phase III randomized controlled trials were included. Methodological quality was generally good. Dual therapy with pegylated interferon was significantly more effective than nonpegylated dual therapy with a pooled sustained virological response rate (SVR) of 55 percent (95 percent confidence interval [CI], 52–58 percent) compared with 46 percent (95 percent CI, 43–49 percent). The pooled relative risk of remaining infected was 0.83 (95 percent CI, 0.76–0.91 percent). Genotype was the strongest predictor of outcome, with SVRs in patients with the more responsive genotypes 2 and 3 reaching up to 80 percent. The incremental cost per quality-adjusted life year (QALY) for pegylated dual therapy compared with nonpegylated dual therapy was £12,123. The cost per QALY remained under £30,000 for most patient subgroups and in sensitivity analyses.
Conclusions: Pegylated interferon is clinically effective, represents good value for the money, and is a significant advance in the treatment of this insidious disease.

This record has no associated files available for download.

More information

Published date: 2 March 2005
Keywords: randomized controlled trials, systematic review, methods, trial, databases, treatment, hepatitis C, chronic, interferons, meta-analysis, quality-adjusted life years

Identifiers

Local EPrints ID: 62114
URI: http://eprints.soton.ac.uk/id/eprint/62114
ISSN: 0266-4623
PURE UUID: d9ce4584-b4d0-4a00-8160-13a9d9f0100c
ORCID for Jonathan Shepherd: ORCID iD orcid.org/0000-0003-1682-4330

Catalogue record

Date deposited: 10 Sep 2008
Last modified: 09 Jan 2022 02:47

Export record

Altmetrics

Contributors

Author: Håkan F.T. Brodin
Author: Carolyn Backer Cave
Author: Norman R. Waugh
Author: Alison Price
Author: John Gabbay

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×