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Pharmacotherapy. 2007 Jun;27(6):813-24.

Peginterferon alfa-2a versus peginterferon alfa-2b as initial treatment of hepatitis C virus infection: a cost-utility analysis from the perspective of the Veterans Affairs Health Care System.

Author information

  • 1Center for Health Outcomes and Pharmacoeconomic Research, College of Pharmacy, University of Arizona, Tucson, Arizona 85721, USA.

Abstract

STUDY OBJECTIVE:

To assess the cost-utility of peginterferon alfa-2a plus ribavirin, peginterferon alfa-2b plus ribavirin, and no therapy for treatment-naïve patients with chronic hepatitis C virus (HCV) infection from the perspective of the Veterans Affairs (VA) health care system by using patient-reported utility scores.

DESIGN:

Cost-utility analysis using a Markov model.

SETTING:

Veterans Affairs health care system.

DATA SOURCE:

Data for the model were obtained from clinical trials and published literature. Data from the VA health care system were used to define the patient cohorts.

MEASUREMENTS AND MAIN RESULTS:

A Markov model incorporating transition probabilities between disease health states that depend only on the current health state was developed to simulate the progression of HCV disease. The patient cohorts were a 45-year-old male cohort and a 55-year-old male cohort, each with liver fibrosis but no cirrhosis. The lifetime expected costs, quality-adjusted life-years (QALYs) gained, and incremental net monetary benefit (INMB) with HCV treatments were determined for each cohort by genotype (genotype 1, and genotypes 2 and 3). Both peginterferon regimens were significantly more cost-effective than no treatment, although no significant differences in costs or QALYs were noted between peginterferon regimens. For the 45-year-old cohort with a genotype 1 infection, the INMB was $128,583 (95% confidence interval [CI] $79,279-$177,308) and $128,025 (95% CI $80,425-$173,448) versus no treatment for peginterferon alfa-2a plus ribavirin and peginterferon alfa-2b plus ribavirin, respectively. Treatment with either peginterferon regimen produced significantly lower lifetime HCV-related medical costs for genotype 2 or 3 infections, but not genotype 1.

CONCLUSIONS:

Peginterferon alfa-2a plus ribavirin and peginterferon alfa-2b plus ribavirin were found to be cost-effective treatments for patients with HCV infections, particularly with genotypes 2 and 3. However, no significant differences in costs or efficacy were observed between these peginterferon treatment regimens.

PMID:
17542764
[PubMed - indexed for MEDLINE]
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