title: Trends in viral hepatitis cost-effectiveness studies.
abstract: Cost-effectiveness analyses compare the value of different treatment strategies, given that one strategy is more effective but also more costly than the other. The results are often used as a pharmacoeconomic basis to support a particular treatment strategy.
  
  
  
  To determine whether studies that reported favorable cost-effectiveness results in the antiviral treatment of hepatitis B and hepatitis C were more likely to be published.
  
  
  
  A systematic literature search was performed to identify all original cost-effectiveness studies published from 1987 through 2011 regarding antiviral treatment of hepatitis B or hepatitis C. Data were abstracted independently by 2 reviewers. Corresponding authors were also contacted.
  
  
  
  Of the 77 original cost-effectiveness analyses, 55 (71.4%) utilized a cost-effectiveness ratio below $50,000 per quality-adjusted life-year (QALY) in reaching a main conclusion for the study. A total of 46 analyses (59.74%) utilized ratios below $20,000/QALY. Most analyses (71 [92.2%]) reported favorable cost-effectiveness results. Countries outside of the United States and Europe tended to report lower cost-effectiveness ratios. Academic-funded studies were less likely to report cost-effectiveness ratios below $20,000/QALY. Most of the corresponding authors stated that their cost-effectiveness studies were published.
  
  
  
  Most published cost-effectiveness analyses regarding antiviral treatment of hepatitis B or hepatitis C reported favorable results. These results may suggest that researchers only attempt cost-effectiveness studies when there is a high likelihood of positive results. Regardless of the explicit cause of the bias, more awareness and scrutiny are needed when utilizing cost-effectiveness studies in decision making.
authors.affiliation: Department of Medicine, Geffen School of Medicine, University of California, Los Angeles, 200 Medical Plaza, Ste 214, Los Angeles, CA 90095-7302, USA. ssaab@mednet.ucla.edu
authors.forename: Sammy
authors.initials: S
authors.lastname: Saab
authors.forename: Young
authors.initials: Y
authors.lastname: Choi
authors.forename: Harman
authors.initials: H
authors.lastname: Rahal
authors.forename: Kun
authors.initials: K
authors.lastname: Li
authors.forename: Myron
authors.initials: M
authors.lastname: Tong
mesh_terms: D000998:Antiviral Agents / Q000191:economics* / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D004359:Drug Therapy, Combination; D006509:Hepatitis B / Q000188:drug therapy*; D006526:Hepatitis C / Q000188:drug therapy*; D006801:Humans; D007372:Interferons / Q000191:economics / Q000627:therapeutic use; D019057:Quality-Adjusted Life Years; D012254:Ribavirin / Q000191:economics / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D012254:Ribavirin; D007372:Interferons