[Does combination therapy of chronic viral hepatitis C with interferon-alpha and ribavirin approach financial limits?].
Until April 1999, interferon alpha was the only licensed medication in Germany for chronic hepatitis C virus infection with proven effectiveness. In two large placebo-controlled studies the combination therapy with interferon alpha and ribavirin confirmed a major improvement of the sustained response compared to the treatment with interferon alone. These results led to the approval in Germany of the combination therapy for patients with chronic hepatitis C without prior interferon therapy and for patients who relapse after an initial response to therapy with interferon alone. The expenses for the two drugs of the combination therapy are, however, very high (about 40,000 DM for one year of treatment). Considering the large number of patients with chronic hepatitis C in Germany (about half a million), it is suggested that more detailed recommendations for the indication of the combination therapy should be elaborated by a group of experts. Using data from the published literature it is shown for two subgroups of patients with chronic hepatitis C that a more differentiated indication for the use of the combination therapy is possible and justified and might help to avoid a more dramatic increase of drug expenses without shortcomings for the patients.
Steimann
R U
RU
Abteilung für Innere Medizin 1 (Schwerpunkte Hepatologie, Gastroenterologie und Endokrinologie), Robert-Bosch-Krankenhaus, Stuttgart.
Bode
J C
JC
D000998:Antiviral Agents / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D004359:Drug Therapy, Combination; D005858:Germany; D019698:Hepatitis C, Chronic / Q000188:drug therapy / Q000191:economics*; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use; D009313:National Health Programs / Q000191:economics; D012254:Ribavirin / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use
D000998:Antiviral Agents; D016898:Interferon-alpha; D012254:Ribavirin