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Cost-effectiveness of pegylated interferon and ribavirin for patients with chronic hepatitis C treated in routine clinical practice

Published online by Cambridge University Press:  31 March 2009

Marina Grishchenko ,
Richard D. Grieve ,
Michael J. Sweeting ,
Daniela De Angelis ,
Brian J. Thomson ,
Stephen D. Ryder  and
William L. Irving
Marina Grishchenko
Affiliation:
H. Lundbeck A/S
Richard D. Grieve
Affiliation:
London School of Hygiene & Tropical Medicine
Michael J. Sweeting
Affiliation:
Medical Research Council
Daniela De Angelis
Affiliation:
Medical Research Council
Brian J. Thomson
Affiliation:
Nottingham University Hospitals
Stephen D. Ryder
Affiliation:
Nottingham University Hospitals
William L. Irving
Affiliation:
Department of Microbiology and Infectious Diseases, University of Nottingham
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Abstract

Objectives: This study assesses whether pegylated interferon and ribavirin is cost-effective compared with no antiviral treatment provided in routine clinical practice, for different patient subgroups.

Methods: The cost-effectiveness analysis (CEA) uses a Markov decision model to estimate the lifetime cost per quality-adjusted life-year (QALY) of antiviral treatment compared with no treatment. The model is populated with data on sustained virological responses, costs, and transition probabilities all taken from a large representative sample of UK cases and centers (Trent HCV database).

Results: The CEA found that pegylated interferon and ribavirin was cost-effective for most patient subgroups. The CEA found that for patients with genotype non-1, the intervention led to cost reductions and gains of at least 0.5 QALYs. For genotype 1 cases with mild or moderate disease, and younger cirrhotic patients (aged 40 or less), costs per QALY remained below £20,000 ($40,000 or €29,000). For genotype 1 cases with cirrhosis aged 50, the mean cost per QALY rose to over £60,000 ($120,000 or €87,000).

Conclusions: The study concludes that, based on cost and effectiveness data collected from routine clinical practice, treatment with pegylated interferon and ribavirin is generally cost-effective. The study shows that there are variations according to patient subgroup and for older (aged 50 or over) genotype 1 patients with cirrhosis, antiviral treatment appears less cost-effective.

Keywords

Chronic hepatitis CDecision-analytic modelRoutine dataCost analysisAntiviral therapy
Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 25 , Issue 2 , April 2009 , pp. 171 - 180
Copyright
Copyright © Cambridge University Press 2009

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