Cost-effectiveness of adjuvant interferon therapy after surgical resection of Hepatitis C-related hepatocellular carcinoma.
BACKGROUND
To evaluate cost-effectiveness of adjuvant interferon therapy used with surgical resection of hepatitis C-related primary hepatocellular carcinoma.


METHODS
We constructed a Markov model that simulated adjuvant interferon therapy after resection of hepatitis C-related hepatocellular carcinoma, and evaluated life expectancy, costs, and cancer recurrence. The reference case is a 60-year-old man with hepatitis C-related compensated cirrhosis.


RESULTS
At the baseline, adjuvant interferon therapy yielded 6.1 life years with a cost of dollars 77000, and an incremental cost-effectiveness ratios of dollars 15700/life year compared with no interferon therapy. The proportion of patients who experienced recurrence of hepatocellular carcinoma until death was reduced from 87.6% to 62.9% using adjuvant interferon therapy. The incidence of recurrent hepatocellular carcinoma after interferon influenced the cost-effectiveness of adjuvant interferon therapy. A threshold analysis showed that adjuvant interferon therapy was not cost-effective (ICER = dollars 27000/year) if the annual incidence of recurrent hepatocellular carcinoma after interferon is 16% (baseline 8.9%). The proportions of patients with recurrent hepatocellular carcinoma were 74.4% and 86.9% at the annual recurrence rates after interferon of 16% and 35%, respectively.


CONCLUSIONS
Adjuvant interferon therapy after surgical resection of primary hepatitis C-related hepatocellular carcinoma improves life expectancy through suppression of recurrent cancer with acceptable cost-effectiveness.
Hoshida
Yujin
Y
Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Japan. hoshiday-int@h.u-tokyo.ac.jp
Shiratori
Yasushi
Y
Omata
Masao
M
D000998:Antiviral Agents / Q000191:economics* / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000191:economics* / Q000209:etiology / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D003362:Cost-Benefit Analysis; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy / Q000191:economics*; D006801:Humans; D007372:Interferons / Q000191:economics* / Q000627:therapeutic use; D008017:Life Expectancy; D008103:Liver Cirrhosis / Q000188:drug therapy / Q000191:economics / Q000209:etiology; D008113:Liver Neoplasms / Q000191:economics* / Q000209:etiology / Q000628:therapy; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local
D000998:Antiviral Agents; D007372:Interferons