Cost-effectiveness analysis of interferon-alpha therapy in the treatment of chronic hepatitis B in Taiwan.
OBJECTIVE
Although interferon-alpha has been approved for chronic hepatitis B treatment in Taiwan, the high price necessitates study of its cost-effectiveness to define its role from a burden of disease perspective.


METHODS
A stimulation model was constructed to project the long-term effects of interferon treatment or standard care for a hypothetical group of 35-year-old chronic hepatitis B patients in Taiwan. Data on interferon treatment efficacy, disease progression, vital statistics, medical expenditure for various liver disease states, and quality-of-life measures based on Taiwan data were collected and used in the model.


RESULTS
The model indicated that a 35-year-old chronic hepatitis B patient treated with interferon in Taiwan would have a life expectancy of 29.08 years, versus 28.67 years for the same patient who did not receive interferon. Corresponding to this gain in life expectancy of 0.41 years (or 0.18 quality-adjusted life-years, QALYs), the incremental cost-effectiveness ratio (ICER) was 492.000 New Taiwan dollars (NT$; 14,200 US$ at 34.7 NT$/US$) per QALY with an annual 3% discount rate. Monte Carlo simulation taking into account the range of plausible values for all model parameters indicated that 95% of the ICERs were in the range of 65,000 NT$ (1.900 US$)/QALY to 683,000 NT$ (19,700 US$)/QALY, and 90% of the ICERs were below 413,000 NT$ (11,900 US$)/QALY.


CONCLUSIONS
Interferon has a favorable cost-effectiveness profile in the treatment of chronic hepatitis B in Taiwan. However, the study results cannot be interpreted in isolation and need to be compared with the cost-effectiveness profiles of treatment regimens for other major chronic diseases in Taiwan.
Pwu
Raoh-Fang
RF
Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei.
Chan
K Arnold
KA
D000328:Adult; D000998:Antiviral Agents / Q000191:economics* / Q000627:therapeutic use; D003198:Computer Simulation; D017281:Cost of Illness; D003362:Cost-Benefit Analysis / Q000379:methods / Q000706:statistics & numerical data; D017048:Health Care Costs; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000191:economics* / Q000401:mortality; D006801:Humans; D016898:Interferon-alpha / Q000191:economics* / Q000627:therapeutic use; D008390:Markov Chains; D019057:Quality-Adjusted Life Years; D013624:Taiwan / Q000453:epidemiology
D000998:Antiviral Agents; D016898:Interferon-alpha