Pretreatment evaluation of chronic hepatitis C - Risks, benefits, and costs

Wong, John B.; Bennett, William G.; Koff, R.S.; Pauker, Stephen G.

doi:10.1097/00042737-199902000-00029

Cited by 62 publications

(87 citation statements)

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“…Overall, the costs of PegIFN alpha 2b are 34.8% higher than those with IFN alpha 2b. However, with the cost-utility calculations, we could observe that, despite of being more expensive, the PegIFN alpha 2b treatment is cost-effective, seen under the WHO point of view related to the Brazilian healthcare market [15,16]. This result does not modify when we separately analyze both patients populations, genotype 1 and non-1 patients.…”

Section: Discussionmentioning

confidence: 82%

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

Fonseca¹,

Araújo²,

Araújo³

2009

Braz J Infect Dis

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Section: Discussionmentioning

confidence: 82%

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

Fonseca¹,

Araújo²,

Araújo³

2009

Braz J Infect Dis

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“…The cost of antiviral treatment included the cost of antiviral drugs, hematologic growth factors, laboratory tests, and clinic visits. [38][39][40][41] Because these costs vary among institutions, a sensitivity analysis over a wide range of drug costs was performed. The cost of dying was estimated in charges and converted using an assumed costcharge ratio of 0.65.…”

Section: Costsmentioning

confidence: 99%

Is it cost-effective to treat recurrent hepatitis C infection in orthotopic liver transplantation patients?

Saab

Han

et al. 2002

Liver Transplantation

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Hepatitis C virus (HCV) recurs in the allograft almost universally after orthotopic liver transplantation (OLT), with a variable course ranging from mild hepatitis to frank cirrhosis. The uncertain prognosis after OLT has lead to widely increased use of antiviral therapy in the post-OLT setting. We compared two scenarios (antiviral therapy versus no antiviral therapy) using a Markov-based decision analytic model to simulate costs and health outcomes for recurrent HCV in three age and sex cohorts of post-OLT patients. Efficacy outcomes included total costs, cases of cirrhosis prevented, cases of death prevented, lifeyears gained, and cost per life-year saved. One-way sensitivity analyses were performed for sustained viral response; annual drug cost, discount rate, compliance, cirrhosis rate, decompensation rate, and cost of dying. Two-way sensitivity analyses were performed to compare effects of (1) changing sustained viral response and antiviral therapy costs, and (2) changing the sustained viral response and cirrhosis rate. The incremental cost-effectiveness ratio for the reference patient cohort of 1,000 men aged 55 years was $29,100 per life-year saved. The model was sensitive to drug costs, cirrhosis rate, and sustained viral response. The two-way sensitivity analysis showed that antiviral therapy remained cost-effective even if drug costs increased, as long as these increases were associated with higher sustained viral responses. The costeffectiveness ratio also was sensitive to age and sex of cohort. The decision to treat HCV after OLT with antiviral therapy usually is based on many considerations. O rthotopic liver transplantation (OLT) is definitive therapy for patients with decompensated liver disease. Whereas the 1-year survival rate in patients with decompensated liver disease is between 50% and 70%, OLT increases survival to almost 90%. 1-4 Hepatitis C virus (HCV) is one of the leading causes of cirrhosis in patients undergoing OLT in the United States. It now accounts for the majority of liver transplantations in the United States. 5 As the population of individuals infected with HCV several decades ago begin to develop liver disease, the number and relative proportion of patients who undergo OLT for HCV is likely to increase further. 6 HCV recurrence is almost universal after OLT.After 5 years, approximately 75% of transplant recipients have recurrent HCV. 7 Recurrence does not appear to affect short-term survival. The 5-year survival rate of patients who undergo OLT for HCV is similar to that of patients who undergo OLT for other causes of decompensated liver disease. 1,[8][9][10] However, HCV recurrence may have an adverse impact on long-term survival after OLT. Between 8% and 31% of patients who undergo OLT for HCV develop cirrhosis in 5 to 7 years. 8,9,[11][12][13][14][15][16] Thus, the clinical impact of HCV may not be seen for almost a decade after OLT. However, a subgroup of individuals who undergo OLT for HCV have an accelerated course and develop decompensation within several months of OLT...

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“…C'est au milieu des années 1990, avec l'apparition de nouveaux schémas thérapeutiques, que la littérature scientifique s'est intéressée plus particulièrement à l'évaluation écono-mique d'alternatives thérapeutiques du VHC (Tableau II) [19][20][21][22][23][24][25]. En comparant trois stratégies de prise en charge (interféron α pendant soit 6 mois, soit 12 mois, soit 12 mois avec interruption à 3 mois en cas de non-réponse) à l'absence de traitement, Joliot et al [19] ont établi la supériorité du traitement par interfé-ron α par rapport à l'absence de traitement puisque celui-ci permet une économie nette dès lors qu'on prend en compte les coûts de prise en charge des cirrhoses qui ne seraient pas « évitées » en l'absence de traitement.…”

Section: La Prise En Compte Des Conséquences à Long Terme Du Dépistagunclassified

“…L'intérêt du traitement en fonction de l'âge du patient au moment de la mise sous traitement a également été évalué [21]. [25] a permis de montrer que la stratégie reposant sur la réalisation d'une PCR pré-sentait le meilleur rapport coût-efficacité marginal (4 870 ¤ soit 32 000 F/QALY), mais conduisait à ne pas traiter 36 % des répondeurs potentiels à long terme. Par comparaison, la mise sous traitement systématique de tous les porteurs d'une hépatique chronique C impliquait une détérioration significative du ratio coût/efficacité (14 200 ¤ soit 93 000 F/QALY).…”

Section: La Prise En Compte Des Conséquences à Long Terme Du Dépistagunclassified

Évaluation économique du dépistage et du traitement de l’hépatite C

2002

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Pretreatment evaluation of chronic hepatitis C - Risks, benefits, and costs

Cited by 62 publications

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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

Is it cost-effective to treat recurrent hepatitis C infection in orthotopic liver transplantation patients?

Évaluation économique du dépistage et du traitement de l’hépatite C

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