title: Economic impact of extended treatment with peginterferon alpha-2a and ribavirin for slow hepatitis C virologic responders.
abstract: It is difficult to achieve a sustained virologic response from antiviral therapy for genotype 1 hepatitis C virus-infected patients without a sufficient virologic response in the early weeks after treatment. However, a recent study has reported on the effectiveness of an extended course of treatment with peginterferon alpha-2a plus ribavirin for slow virologic responders. The aim of this study was to evaluate the economic impact of an extended course of treatment. A Markov cohort model of hepatitis C was designed in order to demonstrate the clinical states, based on the assigned transition probabilities over 30 years. The slow virologic responders treated with an extended 72-week course of therapy could increase by 0.55 the quality-adjusted life years (=15.35-14.80) and reduce the lifetime cost by $2762 (=71 559-69 438) in comparison with those treated by the standard 48-week course. One-way sensitivity analyses did not change the cost-effectiveness. Therefore, the extended 72 weeks of treatment with peginterferon alpha-2a plus ribavirin for slow virologic responders could be cost-effective in comparison with the standard 48 weeks of treatment.
authors.affiliation: Division of Information Science and Biostatistics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. ichirojn@med.niigata-u.ac.jp
authors.forename: J
authors.initials: J
authors.lastname: Nakamura
authors.forename: S-I
authors.initials: SI
authors.lastname: Toyabe
authors.forename: Y
authors.initials: Y
authors.lastname: Aoyagi
authors.forename: K
authors.initials: K
authors.lastname: Akazawa
mesh_terms: D000998:Antiviral Agents / Q000191:economics* / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D016174:Hepacivirus / Q000145:classification / Q000187:drug effects / Q000235:genetics; D006526:Hepatitis C / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000191:economics* / Q000627:therapeutic use*; D015233:Models, Statistical; D011092:Polyethylene Glycols / Q000191:economics* / Q000627:therapeutic use*; D011994:Recombinant Proteins; D012254:Ribavirin / Q000191:economics* / Q000627:therapeutic use*
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a