Cost-effectiveness analysis of therapeutic strategies for patients with chronic hepatitis C previously non-responders to interferon

Juan M. Cabasés (), Ramón San Miguel, Javier Mar, Francisco Guillén and María Butí
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Juan M. Cabasés: Departamento de Economía-UPNA, https://www.unavarra.es/departamento-economia

No 301, Documentos de Trabajo - Lan Gaiak Departamento de Economía - Universidad Pública de Navarra from Departamento de Economía - Universidad Pública de Navarra

Abstract: Background: The efficacy of combination therapy in previous non responders to interferon (IFN) monotherapy with chronic hepatitis C is lower than in naïve patients, and there has been no economic evaluation in this population. Aim: To develop a cost-effectiveness analysis of therapeutic regimens with IFN alpha and ribavirin in previous interferon non-responders. Methods: A Markov simulation model was used to project the clinical and economic outcomes of five different therapeutic strategies including a “no treatment” alternative using the health care system perspective. The effectiveness data for the different doses and durations was obtained from a previously performed meta-analysis. A sensitivity analysis was performed to test robustness of the model, analysing changes in different variables. Results: Applying a 3% discount rate, the standard patient on combination therapy for 12 months showed an increase of 0.80 years and 1.55 quality adjusted life years (QALYs), when comparing combination therapy for 12 months vs. “no treatment” strategy. This option led to an incremental cost-effectiveness ratio of 11,767 euros per year of life gained and 6,073 euros per QALY. Conclusions: Combination therapy with interferon plus ribavirin in previous interferon non-responders shows an incremental cost-effectiveness ratio within the range of some well accepted medical interventions in our health care system.

Keywords: Hepatitis C; Interferon; Markov model; Non-responders; ribavirin. (search for similar items in EconPapers)
Pages: 28 pages
Date: 2003, Revised 2003
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Citations: View citations in EconPapers (1)

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