Cost-effectiveness of pegylated IFN-alpha2b and -2a and ribavirin for chronic hepatitis C treatment.
Pegylated interferon-alpha(2a) (Pegasys, Roche) and pegylated interferon-alpha(2b) (Peg-Intron, Schering-Plough) with ribavirin (Copegus, Roche; Rebetol, Schering-Plough) is now acknowledged as the therapy of choice for chronic hepatitis C. This article reviews the existing evidence concerning the cost-effectiveness of pegylated interferon and ribavirin versus nonpegylated interferon and ribavirin for the treatment of chronic hepatitis C and highlights key issues for future research. Recently published cost-effectiveness analyses suggest that use of pegylated interferon and ribavirin should reduce the cumulative incidence of liver complications, increase life expectancy, improve quality of life, and be cost-effective in comparison with nonpegylated interferon and ribavirin. The cost and benefits of the treatment depend on factors such as patient age, sex, viral load, histological severity and viral genotype. Studies of the natural history of chronic hepatitis C and randomized clinical trials of pegylated interferon and ribavirin versus other therapies need to be performed in special populations of patients to provide valuable data that could be incorporated into future cost-effectiveness analyses. The direct comparison of two marketed pegylated interferons in terms of cost-effectiveness is needed. The cost-effectiveness analyses of the two pegylated combination products should be preceded by a head-to-head clinical trial that would provide evidence of comparative efficacy.
Orlewska
Ewa
E
Poland Medical University of Warsaw, Centre for Pharmacoeconomics, 02-969 Warsaw, Kremowa 13, Poland. ewaorlewska@go2.pl