A systematic review of the cost-effectiveness of peginterferon alfa-2b in the treatment of chronic hepatitis C.
A systematic review was conducted of the full economic evaluations of the cost-effectiveness of peginterferon alfa-2b (PEG-IFN alfa-2b) plus ribavirin (RBV) in the treatment of chronic hepatitis C (CHC). A total of 439 references were screened and 11 studies were included. The studies employed decision analytic Markov models in which hypothetical cohorts of patients progressed through a series of health states characteristic of the natural history of CHC. The studies analyzed various regimens of PEG-IFN alfa-2b plus RBV including stopping rules for different genotypes, and fixed or weight-based dosing of RBV. In all studies, PEG-IFN alfa-2b plus RBV was associated with favorable incremental cost-effectiveness ratios (ICERs) when compared with IFN plus RBV. Tailored treatment according to bodyweight dosing and circumscribed treatment for different genotypes improves ICERs further. Further cost-effectiveness analyses should consider the impact of antiviral treatment in subgroups of patients including those co-infected with HIV, hemophiliacs and patients who are retreated following previous treatment failure, where data are available.
Southampton Health Technology Assessments Centre (SHTAC), Wessex Institute, Mailpoint 728, Boldrewood, University of Southampton, Southampton, SO16 7PX, UK. jps@soton.ac.uk.
Jonathan
J
Shepherd
Jeremy
J
Jones