Health benefits of antiviral therapy for mild chronic hepatitis C: randomised controlled trial and economic evaluation
Wright M, Grieve R, Roberts J, Main J, Thomas H C on behalf of the UK Mild Hepatitis C Trial Investigators
Record ID 32006000744
English
Authors' objectives:
The aim of this document is to determine whether combined therapy with interferon-a and ribavirin was more effective and cost-effective than no treatment for patients with mild chronic hepatitis C.
Authors' results and conclusions:
In the treatment group, 32 out of 98 patients (33%) achieved an SVR. Patients infected with genotype 1 had a lower SVR than those infected with genotype non-1 (18% versus 49%, p = 0.02). No patients who failed to achieve a 2-log drop in viral load at 12 weeks achieved an SVR. HRQoL fell during treatment and rose with treatment cessation. For patients having an SVR there were modest improvements in HRQoL at 6 months post-treatment.
Authors' recommendations:
Based on the evidence collected in this study, interferon-a and ribavirin treatment for mild chronic hepatitis C patients is in general cost-effective at the 30,000 GBP per QALY threshold previously used by policy-makers in the NHS. For patients with chronic hepatitis C aged 65 or over with genotype 1, antiviral treatment at a mild stage does not appear cost-effective. Further research is required on the cost-effectiveness of pegylated interferon and ribavirin, in particular the intervention's long-term impact on HRQoL and health service costs requires further evaluation. Further research is also needed to develop predictive tests, based on pharmacogenomics, that can identify those cases most likely to respond to antiviral therapy. Liver biopsy before treatment no longer appears justified apart from for older patients (aged 65 or over) with genotype 1. However, further research should monitor the impact this strategy would have on costs and outcomes.
Authors' methods:
Randomised controlled trial, economic evaluation
Details
Project Status:
Completed
URL for project:
http://www.hta.ac.uk/1089
Year Published:
2006
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
England, United Kingdom
MeSH Terms
- Antiviral Agents
- Costs and Cost Analysis
- Hepatitis C
Contact
Organisation Name:
NIHR Health Technology Assessment programme
Contact Address:
NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name:
journals.library@nihr.ac.uk
Contact Email:
journals.library@nihr.ac.uk
Copyright:
2009 Queen's Printer and Controller of HMSO
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.