title: Pharmacoeconomic analysis of the treatment of chronic hepatitis C with peginterferon alfa-2a or peginterferon alfa-2b plus ribavirin in Spain.
abstract: BACKGROUND
  An independent meta-analysis of randomized comparative trials of peginterferons alfa-2a and alfa-2b, both combined with ribavirin, analyzed the probability of achieving a sustained virological response (SVR).
  
  
  OBJECTIVE
  To estimate the long-term cost-effectiveness of treatment of patients with chronic hepatitis C with peginterferon alfa-2a (180μg/week) plus ribavirin (800-1200mg/day) vs. alfa-2b (1.5μg/kg/week) plus ribavirin (800-1400mg/day), from the perspective of the Spanish National Health System.
  
  
  METHODS
  A Markov model was developed with 7 health states to simulate lifetime disease progression. SVR was calculated from the meta-analysis data. Transition probabilities and health state utilities were obtained from published literature. Direct healthcare costs were obtained from the drug catalog, while costs of disease-related complications were obtained from published studies and healthcare cost database. Costs were expressed in 2010€. The annual discount rate applied was 3.5% for both costs and benefits.
  
  
  RESULTS
  SVR rate for treatment with alfa-2a was higher than with alfa-2b; the differences were 6.0%, 7.6% and 8.7% for all genotypes, genotypes 1/4 and genotypes 2/3, respectively. Each patient would gain 0.469, 0.600 and 0.685 life-years and 0.155, 0.198 and 0.227 quality-adjusted life-years with alfa-2a vs. alfa-2b, for the respective genotypes. The cost saving per patient treated with alfa-2a would be €705, €672 and €1900, for all genotypes and for genotypes 1/4 and 2/3, respectively, alfa-2a being dominant.
  
  
  CONCLUSIONS
  According to the present model, treatment of patients with chronic hepatitis C with peginterferon alfa-2a is cost-effective compared with peginterferon alfa-2b, both combined with ribavirin.
authors.affiliation: Servicio de Aparato Digestivo, Complejo Hospitalario de Pontevedra, Pontevedra, Spain. Electronic address: jturnesv@gmail.com.
authors.forename: Juan
authors.initials: J
authors.lastname: Turnes
authors.forename: Manuel
authors.initials: M
authors.lastname: Romero-Gómez
authors.forename: Ramón
authors.initials: R
authors.lastname: Planas
authors.forename: Ricard
authors.initials: R
authors.lastname: Solà
authors.forename: Javier
authors.initials: J
authors.lastname: García-Samaniego
authors.forename: Moisés
authors.initials: M
authors.lastname: Diago
authors.forename: Javier
authors.initials: J
authors.lastname: Crespo
authors.forename: José Luis
authors.initials: JL
authors.lastname: Calleja
authors.forename: Carlos
authors.initials: C
authors.lastname: Rubio-Terrés
authors.forename: Pere
authors.initials: P
authors.lastname: Ventayol
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D017048:Health Care Costs; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy / Q000191:economics*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000191:economics* / Q000627:therapeutic use; D016031:Liver Transplantation; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D018803:Models, Economic; D011092:Polyethylene Glycols / Q000191:economics* / Q000627:therapeutic use; D019057:Quality-Adjusted Life Years; D011994:Recombinant Proteins / Q000191:economics / Q000627:therapeutic use; D012254:Ribavirin / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D013030:Spain
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a
keywords: Cost-efficacy; Coste-Efectividad; HCV; Hepatitis C; Interferón pegilado α-2a; Interferón pegilado α-2b; Pegylated interferon α-2a; Pegylated interferon α-2b; VHC