title: Assessment of viral genotype impact to the cost-effectiveness and overall costs of care for PEG-interferon-2α + ribavirine treated chronic hepatitis C patients.
abstract: BACKGROUND
  Pegylated interferon alfa plus ribavirin protocol is currently considered the most efficient hepatitis C treatment. However, no evidence of costs comparison among common viral genotypes has been published.
  
  
  OBJECTIVE
  We aimed to assess core drivers of hepatitis C medical care costs and compare cost effectiveness of this treatment among patients infected by hepatitis C virus with genotypes 1 or 4 (group I), and 2 or 3 (group II).
  
  
  METHODS
  Prospective bottom-up cost-effectiveness analysis from societal perspective was conducted at Infectious Diseases Clinic, University Clinic Kragujevac, Serbia, from 2007 to 2010. There were 81 participants with hepatitis C infection, treated with peg alpha-2a interferon plus ribavirin for 48 or 24 weeks. Economic data acquired were direct inpatient medical costs, outpatient drug acquisition costs, and indirect costs calculated through human capital approach.
  
  
  RESULTS
  Total costs were significantly higher (P = 0.035) in group I (mean ± SD: 12,751.54 ± 5,588.06) compared to group II (mean ± SD: 10,580.57 ± 3,973.02). In addition, both direct (P = 0.039) and indirect (P < 0.001) costs separately were significantly higher in group I compared to group II. Separate comparison within direct costs revealed higher total cost of medical care (P = 0.024) in first compared to second genotype group, while the similar tendency was observed for total drug acquisition (P = 0.072).
  
  
  CONCLUSIONS
  HCV genotypes 1 and 4 cause more severe clinical course require more care and thus incur higher expenses compared to HCV 2 and 3 genotypes. Policy makers should consider willingness to pay threshold differentially depending upon HCV viral genotype detected.
authors.affiliation: Pharmacology and Toxicology Department, The Faculty of Medical Sciences Kragujevac, University of Kragujevac, Kragujevac, Serbia.
authors.forename: Mihajlo
authors.initials: M
authors.lastname: Jakovljevic
authors.forename: Zeljko
authors.initials: Z
authors.lastname: Mijailovic
authors.forename: Biljana Popovska
authors.initials: BP
authors.lastname: Jovicic
authors.forename: Predrag
authors.initials: P
authors.lastname: Canovic
authors.forename: Olgica
authors.initials: O
authors.lastname: Gajovic
authors.forename: Mirjana
authors.initials: M
authors.lastname: Jovanovic
authors.forename: Dejan
authors.initials: D
authors.lastname: Petrovic
authors.forename: Olivera
authors.initials: O
authors.lastname: Milovanovic
authors.forename: Natasa
authors.initials: N
authors.lastname: Djordjevic
keywords: Cost-Benefit Analysis; Hepatitis C, Chronic; Interferons; Ribavirin
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