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Cost‐effectiveness of growth factors during hepatitis C anti‐viral therapy
Author(s) -
CHAPKO M. K.,
DOMINITZ J. A.
Publication year - 2006
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 - 10.1111/j.1365-2036.2006.03089.x
Subject(s) - medicine , erythropoietin , ribavirin , neutropenia , granulocyte colony stimulating factor , pegylated interferon , genotype , immunology , hepatitis c virus , chemotherapy , virus , biology , biochemistry , gene
Summary Background Although the current standard of care for controlling anaemia and neutropenia during anti‐viral therapy for hepatitis C is to use dose reduction of ribavirin and pegylated interferon, respectively, erythropoietin and granulocyte colony‐stimulating factor are now being advocated as alternatives to dose reduction. Aim To determine the cost‐effectiveness of erythropoietin and granulocyte colony‐stimulating factor as an alternative to anti‐viral dose reduction during antihepatitis C therapy. Methods Decision analysis was used to assess cost‐effectiveness by estimating the cost of using a growth factor per quality‐adjusted life‐year gained. Results Under baseline assumptions, the cost per quality‐adjusted life‐year of using growth factors ranged from $16 247 for genotype 1 with neutropenia to $145 468 for genotype 2/3 patients with anaemia. These findings are sensitive to the relationship between dose reduction and sustained virological response. Conclusions Based upon our findings and the varying strength of the evidence for a relationship between dose reduction and sustained virological response: granulocyte colony‐stimulating factor may be cost‐effective for genotype 1 patients; erythropoietin is probably not cost‐effective for genotype 2/3 patients; no conclusion can be reached regarding the cost‐effectiveness of erythropoietin for genotype 1 patients or granulocyte colony‐stimulating factor for genotype 2/3 patients. Randomized trials are needed to firmly establish the relationship between dose reduction and sustained virological response.