Cost effectiveness of peginterferon alfa-2B combined with ribavirin for the treatment of chronic hepatitis C in Brazil

Cost effectiveness of peginterferon alfa-2B combined with ribavirin for the treatment of chronic hepatitis C in Brazil

Author Fonseca, Marcelo Cunio Machado Autor UNIFESP Google Scholar
Araujo, Gabriela Tannus Branco de Autor UNIFESP Google Scholar
Araujo, Denizar Vianna Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
State University of Rio de Janeiro
Abstract The treatment of chronic hepatitis C (CHC) with peginterferon alpha-2b/ribavirin (PegIFN + Rib) produced larger sustained viral response (SVR) compared to the conventional (non-pegylated) interferon/ribavirin (IFN + Rib), but its cost-effectiveness was not assessed in Brazil. We developed a Markov model to mirror the natural disease history and cohorts of patients with hepatitis C virus (HCV), that received PegIFN + Rib or IFN + Rib treatment for 48 or 24 weeks, according to viral genotype and liver histology. The SVRs for the treatments PegIFN + Rib and IFN + Rib were respectively 48% and 34% (genotype 1), and 88% and 80% (genotype non-1). Three Delphi panels were conducted with hepatologists and intensivists, and another one with oncologists. The costs are expressed in 2006 Brazilian Reais (R$) and the benefits were discounted at 3%. In genotype 1 HCV patients, PegIFN + Rib increases the life expectancy (LE) in 0.51 year, and the quality-adjusted life years (QALY) in 0.78, as compared to IFN + Rib. In genotype non-1 HCV patients, PegIFN + Rib increases the LE in 0.29 years and the QALY in 0.44 years, as compared to IFN + Rib. The incremental cost-effectiveness rate, considering all the genotypes, was of R$19,848.34 per QALY. Peginterferon alpha-2b with ribavirin is a cost-effective therapy for the treatment of naïve CHC adult patients compared to the interferon alpha-2b and ribavirin regime, irrespective of the viral genotype.
Keywords Hepatitis C
cost-benefit analysis
effectiveness
interferons
Language English
Date 2009-06-01
Published in Brazilian Journal of Infectious Diseases. Brazilian Society of Infectious Diseases, v. 13, n. 3, p. 191-199, 2009.
ISSN 1413-8670 (Sherpa/Romeo, impact factor)
Publisher Brazilian Society of Infectious Diseases
Extent 191-199
Origin http://dx.doi.org/10.1590/S1413-86702009000300007
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000275105600007
SciELO ID S1413-86702009000300007 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/5059

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