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Gut. 2006 Sep;55(9):1332-8. Epub 2005 Jun 30.

Cost effectiveness of interferon alpha or peginterferon alpha with ribavirin for histologically mild chronic hepatitis C.

Author information

  • 1Health Services Research Unit, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK. richard.grieve@lshtm.ac.uk

Abstract

BACKGROUND:

For patients with mild chronic hepatitis C the cost effectiveness of antiviral therapy is unknown.

AIMS:

To assess whether antiviral therapy (either interferon alpha or peginterferon alpha combined with ribavirin) is cost effective at a mild stage compared with waiting and only treating those cases who progress to moderate disease.

PATIENTS:

Cases with mild chronic hepatitis C.

METHODS:

A cost effectiveness model which 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 randomised controlled trial, 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 alpha-2b and ribavirin, compared with no treatment at a mild stage, was 4535 pounds sterling (7108 dollars) for patients with genotype non-1 and 25,188 pounds sterling (39,480 dollars) for patients with genotype 1. Providing peginterferon alpha-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 7821 pounds sterling (12,259 dollars) for patients with genotype non-1 and 28,409 pounds sterling (44,528 dollars) 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 years or over) with genotype 1, antiviral treatment at a mild stage is not cost effective.

PMID:
15994216
[PubMed - indexed for MEDLINE]
PMCID:
PMC1860032
Free PMC Article
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