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Cost‐effectiveness analysis of therapeutic strategies for patients with chronic hepatitis C previously not responding to interferon
Author(s) -
San Miguel R.,
Mar J.,
Cabasés J. M.,
GuilléNGrima F.,
Buti M.
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.1365-2036.2003.01494.x
Subject(s) - medicine , ribavirin , quality adjusted life year , hepatitis c , cost effectiveness analysis , combination therapy , population , cost effectiveness , interferon , quality of life (healthcare) , chronic hepatitis , alpha interferon , intensive care medicine , immunology , environmental health , virus , risk analysis (engineering) , nursing
Summary Background : The efficacy of combination therapy in patients with chronic hepatitis C previously not responding to interferon monotherapy is lower than that in naive patients, and there has been no economic evaluation in this population. Aim : To develop a cost‐effectiveness analysis of therapeutic regimens with interferon‐alpha and ribavirin in previous interferon non‐responders. Methods : A Markov simulation model was used to project the clinical and economic outcomes of five different therapeutic strategies, including a ‘no treatment’ alternative, using the health care system perspective. The efficacy data for the different doses and durations were obtained from a previously performed meta‐analysis. A sensitivity analysis was performed to test the robustness of the model, analysing changes in different variables. Results : Applying a 3% discount rate, the standard patient on combination therapy for 12 months showed increases of 0.80 years and 1.55 quality‐adjusted life years, when compared with the ‘no treatment’ strategy. This option led to an incremental cost‐effectiveness ratio of 11 767 euros per year of life gained and 6073 euros per quality‐adjusted life year. Conclusions : Combination therapy with interferon plus ribavirin is cost‐effective in previous interferon non‐responders and is within the range of some well‐accepted medical interventions in our health care system.