[Chronic hepatitis C. Combination therapy IFN and ribavirin]

Danish Centre for Evaluation and Health Technology Assessment (formerly DIHTA)
Record ID 32002000827
Authors' objectives:

This report aims to compare the effect of treatment with interferon (IFN) plus ribavirin and the treatment with IFN alone on patients with chronic hepatitis C.

Authors' recommendations: Fifty per cent of patients with chronic hepatitis C virus (HCV) infection will probably never develop symptoms or a liver disease. Fifty per cent will develop a liver disease and perhaps symptoms hereof in the course of a great many years. However, in a minority of the patients chronic hepatitis C may develop into a life threatening chronic liver disease. The group of HCV infected patients is anticipated to be a maximum of 11,000 persons. Fifty per cent of these, i.e. 5,500 persons, are estimated to suffer from chronic hepatitis. Many of these patients are unknown to the health care system, and amongst the patients with a diagnosis not all will be able to benefit from treatment. The number of patients who are candidates for treatment will within the next 10 years not exceed 200 per year, not even if we take into account that there will be more focus on the disease, and the diagnostic procedures might be altered.The combination treatment with IFN and ribavirin can permanently eliminate HCV from the blood and thus cure and prevent a liver disease in approx. 40% of all treated patients. The combination treatment has quite a few side effects, some of which can be serious or permanent, such as interference with thyroid function. Being offered treatment and the treatment itself are considered to be unambiguously good by the patients. Despite the side effects the patients will recommend the treatment to other patients. A decision to offer the combination treatment to all patients who could possibly benefit from the treatment can be implemented within the framework of the existing health care system. A decision to offer treatment is not considered to require organisational changes in the individual departments/clinics, between departments or at the hospital level. With the present rather high price of IFN and ribavirin and with the conservative estimates of costs related to health care services offered to patients with advanced liver disease, the health economic analysis shows that treatment with a combination of IFN and ribavirin from a health economic point of view will only be beneficial seen in a very long scope of time. Based upon all the stated considerations the working group will recommend that the combination treatment with IFN and ribavirin should be offered to patients with chronic hepatitis C who fulfil the criteria for treatment as stated in this report.
Authors' methods: Systematic review
Project Status: Completed
Year Published: 2002
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Denmark
MeSH Terms
  • Interferons
  • Ribavirin
  • Hepatitis C
Organisation Name: Danish Centre for Evaluation and Health Technology Assessment
Contact Address: National Board of Health, PO Box 1881, Islands Brygge 67, DK-2300 Copenhagen S, Denmark. Tel: 45 72 22 74 48; Fax: 45 72 22 74 07/67
Contact Name: dacehta@sst.dk
Contact Email: dacehta@sst.dk
Copyright: Danish Centre for Evaluation and Health Technology Assessment (DACEHTA) (formerly DIHTA)
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