To estimate the cost-effectiveness of interferon-alpha2B for the treatment of patients with chronic hepatitis B infection who are positive for hepatitis B e antigen (HBeAg).
Meta-analysis of nine randomized controlled trials and cost-effectiveness analysis, projecting the clinical and economic outcomes expected from changes in serologic markers of hepatitis B viral replication.
MEDLINE search, expert panel opinion, hospital cost data, and adjusted physician charges.
552 patients with confirmed chronic hepatitis B infection who were positive for HBeAg.
Interferon-alpha2b increases the likelihood of becoming negative for HBeAg from 9.1% to 45.6% (difference, 36.5% ; 95% CI, 23.7% to 49.2%) and of becoming negative for hepatitis B surface antigen from 1.7% to 7.7% (difference, 6.0% ; CI, 2.8% to 9.3%) in the first year.
For a 35-year-old person with chronic hepatitis B who is HBeAg positive, our analysis suggests that interferon-alpha2b will increase life expectancy by 3.1 years or 3.4 quality-adjusted life-years and will decrease projected lifetime costs, even if future savings are discounted.
Even with the model biased strongly in favor of standard care, the marginal cost-effectiveness ratio of interferon did not exceed $12 000 per life-year gained.
Interferon-alpha2b should prolong life and lower costs for patients with chronic hepatitis B who are HBeAg positive.
Mots-clés Pascal : Hépatite virale B, Virose, Infection, Chronique, Interféron alpha, Coût, Chimiothérapie, Traitement, Homme, Economie santé, Antigène HBe, Appareil digestif pathologie, Foie pathologie, Cytokine
Mots-clés Pascal anglais : Viral hepatitis B, Viral disease, Infection, Chronic, Alpha interferon, Costs, Chemotherapy, Treatment, Human, Health economy, Hepatitis B e antigen, Digestive diseases, Hepatic disease, Cytokine
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0328076
Code Inist : 002B02Q. Création : 01/03/1996.