Pegylated interferon combined with ribavirin for chronic hepatitis C virus infection: an economic evaluation
Brady B, Siebert U, Sroczynski G, Murphy G, Husereau D, Sherman M, Wong W, Mensinkai S
Record ID 32007000131
English
Authors' objectives:
The objective of this report was to assess the cost-effectiveness of PegIFN plus RBV (Pegetron and Pegasys RBV) to treat adults in Canada who have CHC infection. The focus was on the treatment of those who have not been treated with IFN- or PegIFN-based therapies (i.e., treatment nave), those who have elevated alanine aminotransferase (ALT) levels, and those who are indicated for antiviral therapy (AVT) according to clinical practice guidelines in Canada. The comparators for the analysis were standard (non-Peg) IFN plus RBV, and no AVT. The cost-effectiveness of AVT in patients with mild CHC (i.e., patients with minimal to mild fibrosis and mild inflammation) was also assessed.
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 Canadaian dollars of additional lifetime costs per patient. IFN+RBV was associated with 0.51 QALYs gained and 11,500 Canadaian 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 Canadaian 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:
Systematic review, Cost study
Details
Project Status:
Completed
Year Published:
2007
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Canada
MeSH Terms
- Hepatitis C
- Interferons
Contact
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)
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.