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A cost‐effectiveness analysis of peginterferon alfa‐2b plus ribavirin for the treatment of naive patients with chronic hepatitis C
Author(s) -
Buti M.,
Medina M.,
Casado M. A.,
Wong J. B.,
Fosbrook L.,
Esteban R.
Publication year - 2003
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2003.01453.x
Subject(s) - ribavirin , medicine , euros , chronic hepatitis , hepatitis c , quality adjusted life year , quality of life (healthcare) , cost effectiveness , peginterferon alfa 2a , cost effectiveness analysis , gastroenterology , virology , philosophy , virus , risk analysis (engineering) , nursing , humanities
Summary Aim : To estimate the cost‐effectiveness of therapy and analyse the effect of therapy compliance in naive patients with chronic hepatitis C. Methods : A decision analysis using the Markov model was performed for four different therapeutic strategies using peginterferon alfa‐2b plus ribavirin or interferon alfa‐2b plus ribavirin. Clinical data were obtained from available published reports and from the Spanish health system perspective. Results : The incremental cost‐effectiveness ratio of peginterferon alfa‐2b plus ribavirin at a fixed dose, compared with interferon alfa‐2b plus ribavirin, was 8478 euros per life year saved and 3737 euros per quality‐adjusted life year gained. Good therapeutic compliance and weight‐adjusted doses of ribavirin decreased the incremental cost‐effectiveness ratio to 1636 euros per life year saved and 721 euros per quality‐adjusted life year gained. In compliant genotype 1 patients, the incremental cost‐effectiveness ratio decreased to 916 euros per life year saved and 404 euros per quality‐adjusted life year gained, with an increase from 64 to 69 years in the threshold age at which therapy was cost‐effective. The sensitivity analysis demonstrated that changes in the values of the most relevant parameters do not modify the study outcomes. Conclusion : From the clinical and pharmaco‐economics perspective, the use of decision therapeutic analysis models suggests that the most effective therapy for chronic hepatitis C is peginterferon alfa‐2b plus ribavirin adjusted to patient body weight and with good compliance, particularly in genotyped patients.