title: [Cost-effectiveness analysis of the treatment of chronic hepatitis C].
abstract: OBJECTIVE
  Chronic active hepatitis C is an important public health issue because of its prevalence, evolution, and overall cost. Treatment by recombinant alpha-interferon is both expensive and exacting and its effectiveness is limited. We report the results of a cost-effectiveness analysis of alpha-interferon treatment in patients with chronic active hepatitis C.
  
  
  METHODS
  Direct medical costs of caring for patients with chronic active hepatitis C and its complications, based on treatment or no treatment, were assessed with retrospective data collected from the files of 137 hospital patients. Seventy-seven patients were treated with alpha-interferon between 1988 and 1994. The overall costs of caring for chronic active hepatitis C patients, without treatment or with alpha-interferon treatment (3 millions units three times a week) for 6 months (strategy A), 12 months (strategy B), or 12 months but discontinuing treatment when there was no response (strategy C), was reported and compared to the respective effectiveness of each.
  
  
  RESULTS
  With an actualization rate of 5%, the real overall cost of caring for a chronic active hepatitis C patient was 143290 FF. Considering the contraindication rate (15%), the treatment acceptance (85%), the response rate to treatment (50%), and the prolonged response rate (25 to 30%), treating patients with strategy A induced a real overall cost of caring to 140731 FF to avoid 0.11 cases of cirrhosis, to 150277 FF to avoid 0.13 cases of cirrhosis with strategy B, and to 136947 FF to avoid 0.13 cases of cirrhosis with strategy C.
  
  
  CONCLUSIONS
  Alpha-interferon treatment in patients with chronic active hepatitis C provides a long-term saving compared to cases which receive no treatment. Strategy C was the most cost-effective, inducing the reduction of both the number of cases of cirrhosis and the cost of care.
authors.affiliation: Service d'Hépatologie, CHU, Besancon.
authors.forename: E
authors.initials: E
authors.lastname: Joliot
authors.forename: C
authors.initials: C
authors.lastname: Vanlemmens
authors.forename: M
authors.initials: M
authors.lastname: Kerleau
authors.forename: C
authors.initials: C
authors.lastname: Le Gales
authors.forename: M C
authors.initials: MC
authors.lastname: Woronoff-Lemsi
authors.forename: Y A
authors.initials: YA
authors.lastname: Flori
authors.forename: V
authors.initials: V
authors.lastname: Seror
authors.forename: S
authors.initials: S
authors.lastname: Hrusovsky
authors.forename: E
authors.initials: E
authors.lastname: Monnet
authors.forename: S
authors.initials: S
authors.lastname: Bresson-Hadni
authors.forename: J P
authors.initials: JP
authors.lastname: Miguet
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000191:economics* / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D005260:Female; D006526:Hepatitis C / Q000191:economics* / Q000503:physiopathology / Q000628:therapy; D006521:Hepatitis, Chronic / Q000191:economics* / Q000503:physiopathology / Q000628:therapy; D006760:Hospitalization / Q000191:economics; D006801:Humans; D016898:Interferon-alpha / Q000191:economics* / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000191:economics / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha