Interferon-alpha is effective in only a small number of patients with chronic hepatitis C, although prolonged treatment may increase the response rate.
There is concern that the expense of interferon-alpha therapy may not be justified by the low response rates and uncertain long-term benefit.
To compare clinical and economic outcomes after 6 months and 12 months of interferon-alpha therapy for chronic hepatitis C. Design : A Markov model depicting the natural progression of chronic hepatitis C. On the basis of this model, a simulated trial compared no therapy with 6 and 12 months of interferon-alpha therapy at standard doses (3 million U three times weekly).
Four age-specific cohorts (30,40,50, and 60 years of age) with chronic hepatitis C. Measurements : Number of deaths from liver disease, total costs, and cumulative quality-adjusted life-years (QALYs).
Six and 12 months of interferon-alpha treatment gained 0.25 QALYS at an incremental cost of $1000 and 0.37 QALYs at an incremental cost of $1900, respectively.
Thus, although 6 months of interferon-alpha therapy was less efficacious than 12 months of therapy, it was more cost-effective ($4000 per QALY gained compared with $5000 per QALY gained).
Nonetheless, in patients younger than 60 years of age, both 6 and 12 months of therapy compared favorably with other established medical interventions, such as screening mammography and cholesterol reduction programs. (...)
Mots-clés Pascal : Hépatite virale C, Virose, Infection, Chronique, Etude cohorte, Interféron alpha, Etude comparative, Coût, Modèle Markov, Efficacité traitement, Critère âge, Evaluation, Temps prise, Homme, Etats Unis, Amérique du Nord, Amérique, Appareil digestif pathologie, Foie pathologie, Cytokine, Technique, Economie santé
Mots-clés Pascal anglais : Viral hepatitis C, Viral disease, Infection, Chronic, Cohort study, Alpha interferon, Comparative study, Costs, Markov model, Treatment efficiency, Age criterion, Evaluation, Setting time, Human, United States, North America, America, Digestive diseases, Hepatic disease, Cytokine, Technique, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0042456
Code Inist : 002B05C02G. Création : 17/04/1998.