A health economic model to assess the long term effects and cost-effectiveness of PEG IFN alpha-2a in hepatitis C virus infected patients.
OBJECTIVE
Chronic Hepatitis C (CHC) is associated with long-term complications. Treating CHC with Pegylated interferon alpha-2a (PEG IFN alpha-2a) improves response rates and may contribute to less morbidity and mortality compared to standard interferon therapy. The objectives of this study were to estimate the long-term clinical consequences of such treatment as well as the resulting cost-effectiveness.


METHODS
A Markov model was developed in order to predict the clinical and economic outcomes over a 25 year period. Three analyses were conducted: 1. for all Hepatitis C Virus (HCV) genotypes where PEG IFN alpha-2a was compared to interferon alpha-2a (IFN alpha-2a) in monotherapy for 48 weeks; 2. for the HCV genotypes 1-4-5-6 comparing PEG IFN alpha-2a with interferon alpha-2b (IFN alpha-2b) both combined with ribavirin 1000/1200 mg for 48 weeks; and 3, where PEG IFN alpha-2a with 800 mg ribavirin was compared to IFN alpha-2b with ribavirin 1000/1200 mg for 24 weeks in genotypes 2 and 3.


RESULTS
In analysis one the cost-effectiveness of PEG IFN alpha-2a is 4,569/quality adjusted life year (QALY) gained. In the second analysis, the result was 14,763 euros/QALY, while for the 24 weeks therapy (analysis 3) the result was 903 per QALY gained. In an extensive sensitivity analysis cost-effectiveness was confirmed within reasonable assumptions.


CONCLUSIONS
These results suggest that PEG IFN alpha-2a is cost-effective in the management of all CHC patients. Real life evidence about longer term benefits of PEG IFN alpha-2a will be of importance for future decision making.
Annemans
L
L
HEDM, Meise, Belgium. lieven.annemans@hedm.be
Warie
H
H
Nechelput
M
M
Peraux
B
B
D000998:Antiviral Agents / Q000191:economics* / Q000627:therapeutic use*; D001530:Belgium; D003362:Cost-Benefit Analysis; D004359:Drug Therapy, Combination; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000191:economics; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000191:economics* / Q000627:therapeutic use*; D018803:Models, Economic; D011092:Polyethylene Glycols / Q000191:economics* / Q000627:therapeutic use*; D011237:Predictive Value of Tests; D011994:Recombinant Proteins; D012254:Ribavirin / Q000191:economics / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a