A health economic model to assess the cost-effectiveness of pegylated interferon α-2a and ribavirin in patients with moderate chronic hepatitis C and persistently normal alanine aminotransferase levels

Gerkens, Sophie;Nechelput, Myriam;Annemans, Lieven;Peraux, Bénédict;Horsmans, Yves;et.al.
(2007) Acta Gastro-Enterologica Belgica (Multilingual Edition) — Vol. 70, n° 2, p. 177-187 (2007)

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Authors
  • Gerkens, SophieUCLouvain
    Author
  • Nechelput, Myriam
    Author
  • Annemans, Lieven
    Author
  • Peraux, Bénédict
    Author
  • Beguin, ClaireUCLouvain
    Author
  • Horsmans, YvesUCLouvain
    Author
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Abstract
Background and study aims: The treatment of patients with moderate chronic hepatitis C and persistently normal alanine aminotransferase levels is still under discussion and the cost-effectiveness of such strategy is unknown. The objective of this study was to estimate the cost-effectiveness of their treatment in comparison with no treatment. Patients and methods: The assessed treatment is composed of pegylated interferon α-2a and ribavirin, which is the current standard treatment. Two groups were studied : patients with genotype 1 and patients with genotypes 2-3. At the beginning of the study, patients were aged of 45. Long-term economic and clinical outcomes over a 30 year period were predicted using a Markov simulation model. A health care payer perspective was chosen. Data were obtained from published literature. Variations of uncertainty parameters were assessed through a sensitivity analysis. Results: The incremental cost-effectiveness ratios (ICERs) were € 5,338/QALY for genotype 1 and € 1,080/QALY for genotypes 2-3. In the sensitivity analysis, ratios remained lower than € 20,000. A Monte Carlo simulation with 1,000 iterations gives a 95% confidence interval for the ICER of € 3,199 to € 8,972 for genotype 1 and € 56 to € 1,981 for genotypes 2-3. Conclusion: Even though the treatment of these patients generates a cost, it has the advantage that in comparison with no treatment, a great number of people are cured, complications are less frequent and patients gain more quality-adjusted life-year (QALY), which involves an ICER considered as acceptable for the European society (< € 20,000).
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Gerkens, S., Nechelput, M., Annemans, L., Peraux, B., Beguin, C., & Horsmans, Y. (2007). A health economic model to assess the cost-effectiveness of pegylated interferon α-2a and ribavirin in patients with moderate chronic hepatitis C and persistently normal alanine aminotransferase levels. Acta Gastro-Enterologica Belgica (Multilingual Edition), 70(2), 177-187. https://hdl.handle.net/2078.5/191001 (Original work published 2007)