Cost-effectiveness of peginterferon alpha-2b plus ribavirin compared with interferon alpha-2b plus ribavirin for initial treatment of chronic hepatitis C

Siebert, Uwe; Sroczynski, Gaby; Rossol, S.; Wasem, J; Ravens‐Sieberer, Ulrike; Kurth, Baerbel M.; Manns, Michael P.; Hutchison, J.G. Mc; Wong, John B.

doi:10.1016/s0168-8278(02)80463-9

Cited by 4 publications

(11 citation statements)

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“…In patients with a sustained virological response, this strategy decreases future liver complications, such as decompensated cirrhosis, hepatocellular carcinoma and liver-related death, prolongs life expectancy by over 4 years compared with no anti-viral therapy, 7 and has a better cost-effectiveness than many other well-accepted medical interventions. Several cost-effectiveness studies on the therapy of chronic hepatitis C have been published, analysing the effect of different drugs (interferon, pegylated interferon and ribavirin) and different drug dosages in 'naive' patients.…”

Section: Discussionmentioning

confidence: 99%

“…The model uses probabilities of progression from chronic hepatitis to cirrhosis, decompensated liver disease and finally death obtained from the results of several different published studies that have been validated previously. [7][8][9][10][11][12][13] The time that patients remain in each clinical stage, the resources used and the treatment costs for the different strategies have been estimated from data published in a previous study. 9 …”

Section: Decision Analysis Modelmentioning

confidence: 99%

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A cost‐effectiveness analysis of peginterferon alfa‐2b plus ribavirin for the treatment of naive patients with chronic hepatitis C

Buti

Medina²,

Casado³

et al. 2003

Aliment Pharmacol Ther

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SUMMARYAim: 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.

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Section: Discussionmentioning

confidence: 99%

Section: Decision Analysis Modelmentioning

confidence: 99%

A cost‐effectiveness analysis of peginterferon alfa‐2b plus ribavirin for the treatment of naive patients with chronic hepatitis C

Buti

Medina²,

Casado³

et al. 2003

Aliment Pharmacol Ther

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“…43 The transition rate from chronic to susceptible (r CS ) reflects both spontaneous remission (0.002 per person per year) and treatment. According to Siebert et al 44 , 61% of people respond to treatment over a 16-year period, suggesting an average annual rate of 0.61/16 = 0.038125, for a combined rate of about r CS = 0.04.…”

Section: End Of Planning Horizonmentioning

confidence: 99%

“…We use Siebert et al's 44 Markov model to predict the HCV epidemic and related costs and incorporated productivity losses per life year lost. 46 Total social costs are dominated by mortality.…”

Section: Parameterising the Model For Vienna Austria: Objective Funcmentioning

confidence: 99%

Modelling the spread of hepatitis C via commercial tattoo parlours: implications for public health interventions

2007

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Hepatitis C (HCV) is a serious infection caused by a blood-borne virus. It is a contagious disease spreading rapidly via a variety of transmission mechanisms including contaminated tattoo equipment. Effectively regulating commercial tattoo parlours can greatly reduce this risk. This paper models the cost-effectiveness and optimal timing of such interventions, and parameterizes the model with data for Vienna, Austria. This dynamic model of the contagious spread of HCV via tattooing and other mechanisms accounts for secondary infections and shows that regulation can be highly cost-effective.

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“…1,[6][7][8][9][10] Prior studies have demonstrated that treatment of chronic hepatitis C with pegylated interferon (PEG IFN) and ribavirin is a cost-effective measure in the general population. [10][11][12][13][14][15][16][17][18][19][20][21][22][23] However, no study has yet addressed whether combination therapy would be cost-effective in the prison population. This study aims to answer this question in the male prison population, which makes up 87.3% of the inmate population.…”

mentioning

confidence: 99%

Treating hepatitis C in the prison population is cost-saving

2008

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The prevalence of chronic hepatitis C infection in U.S. prisons is 12% to 31%. Treatment of this substantial portion of the population has been subject to much controversy, both medically and legally. Studies have demonstrated that treatment of chronic hepatitis C with pegylated interferon (PEG IFN) and ribavirin is a cost-effective measure in the general population; however, no study has addressed whether the same is true of the prison population. The aim of this study was to determine the cost-effectiveness of hepatitis C treatment with PEG IFN and ribavirin in the U.S. prison population. Cost-effectiveness was determined via a decision analysis model employing Markov simulation. The cohort of prisoners had a distribution of genotypes and stages of fibrosis in accordance with prior studies evaluating inmate populations. The probability of transitioning from one health state to another, reinfection rates, in-prison and out-of-prison mortality rates, sustained viral response rates, costs, and quality of life weights were also obtained from the literature. Sensitivity analysis was performed. In a strategy without a pretreatment liver biopsy, treatment was cost-effective for all ages and genotypes. This model was robust to rates of disease progression, mortality rates, reinfection rates, sustained viral response rates, and costs. In a strategy employing a pretreatment liver biopsy, treatment was also cost-saving for prisoners of all ages and genotypes with portal fibrosis, bridging fibrosis, or compensated cirrhosis.

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Cost-effectiveness of peginterferon alpha-2b plus ribavirin compared with interferon alpha-2b plus ribavirin for initial treatment of chronic hepatitis C

Cited by 4 publications

References 0 publications

A cost‐effectiveness analysis of peginterferon alfa‐2b plus ribavirin for the treatment of naive patients with chronic hepatitis C

A cost‐effectiveness analysis of peginterferon alfa‐2b plus ribavirin for the treatment of naive patients with chronic hepatitis C

Modelling the spread of hepatitis C via commercial tattoo parlours: implications for public health interventions

Treating hepatitis C in the prison population is cost-saving

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