Authors' objectives:

The objectives were to assess the clinical and cost-effectiveness of IFN-based combination drug therapies in adults experiencing CHC, who have not been treated previously with PegIFN or IFN-based therapies. The comparators for the clinical outcomes analysis were IFN alone, IFN+RBV, and PegIFN+RBV. The comparators for the cost-effectiveness analysis were no antiviral therapy (AVT), IFN+RBV, and PegIFN+RBV.

Authors' results and conclusions: The net health impact was estimated using a decision-analytic model in terms of quality-adjusted life years (QALYs) and life years (LYs) saved, from the perspective of Canadian ministries of health. The analysis compared PegIFN+RBV to IFN+RBV, and to no antiviral therapy. The simulated population (base case) had an average age of 43 years, with a mix of liver disease states, hepatitis C virus genotypes, and sex, consistent with the Canadian CHC population.

Authors' recommendations: Implications for Decision Making Antiviral therapies may improve health but are not cost saving. Compared to no therapy and after discounting future costs and effects, PegIFN+RBV was associated with 0.70 QALYs gained and 11,800 Canadian dollars of additional lifetime costs per patient. IFN+RBV was associated with 0.51 QALYs gained and 11,500 Canadian dollars of additional lifetime costs per patient. Treating mild CHC can be less effective and consumes additional resources. Compared to no therapy and after discounting future costs and effects, PegIFN+RBV was associated with 0.30 QALYs gained and 14,900 Canadian dollars of additional lifetime costs per patient. Genotype, age, and disease progression rate affect the efficiency of treatment. The additional health system costs to obtain a QALY increase as the disease progression rate decreases and as the age of initiating therapy increases. Treating genotypes 2 and 3 infections costs less per QALY than treating patients with other genotypes. Important factors that affect optimal treatment decisions are still unknown. There are knowledge gaps about CHC, factors affecting a patient's prognosis, and the effect of treatment on disease progression across patient subgroups.

Authors' methods: Overview, Cost study

Project Status: Completed

URL for project: http://www.cadth.ca/index.php/en/hta/reports-publications/search/publica tion/698

Year Published: 2007

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Canadian Agency for Drugs and Technologies in Health

Contact Address: 600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553; Fax: +1 613 226 5392;

Contact Name: requests@cadth.ca

Contact Email: requests@cadth.ca

Copyright: Canadian Agency for Drugs and Technologies in Health (CADTH)