Cost-effectiveness of 6 and 12 months of interferon-α therapy for chronic hepatitis C

W. Ray Kim, John J. Poterucha, John E. Hermans, Terry M Therneau, E. Rolland Dickson, Roger W. Evans, John B. Gross

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Abstract

Background: Interferon-α 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-α therapy may not be justified by the low response rates and uncertain long-term benefit. Objective: To compare clinical and economic outcomes after 6 months and 12 months of interferon-α 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-α therapy at standard doses (3 million U three times weekly). Patients: 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). Results: Six and 12 months of interferon-α 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-α 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. Important variables affecting the cost-effectiveness of interferon-α treatment included the cost and efficacy of interferon-α, the cost of treatment for decompensated cirrhosis, and quality of life in patients with chronic hepatitis C. Conclusion: From the standpoint of cost-effectiveness, interferon-α therapy for 6 or 12 months may be justified in patients with chronic hepatitis C. The possible exception is patients older than 60 years of age.

Original languageEnglish (US)
Pages (from-to)866-874
Number of pages9
JournalAnnals of Internal Medicine
Volume127
Issue number10
StatePublished - Nov 15 1997

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Chronic Hepatitis C
Interferons
Cost-Benefit Analysis
Quality-Adjusted Life Years
Therapeutics
Costs and Cost Analysis
Health Care Costs
Cost of Illness
Mammography
Liver Diseases
Fibrosis
Cholesterol
Economics
Quality of Life

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Kim, W. R., Poterucha, J. J., Hermans, J. E., Therneau, T. M., Dickson, E. R., Evans, R. W., & Gross, J. B. (1997). Cost-effectiveness of 6 and 12 months of interferon-α therapy for chronic hepatitis C. Annals of Internal Medicine, 127(10), 866-874.

Cost-effectiveness of 6 and 12 months of interferon-α therapy for chronic hepatitis C. / Kim, W. Ray; Poterucha, John J.; Hermans, John E.; Therneau, Terry M; Dickson, E. Rolland; Evans, Roger W.; Gross, John B.

In: Annals of Internal Medicine, Vol. 127, No. 10, 15.11.1997, p. 866-874.

Research output: Contribution to journalArticle

Kim, WR, Poterucha, JJ, Hermans, JE, Therneau, TM, Dickson, ER, Evans, RW & Gross, JB 1997, 'Cost-effectiveness of 6 and 12 months of interferon-α therapy for chronic hepatitis C', Annals of Internal Medicine, vol. 127, no. 10, pp. 866-874.
Kim WR, Poterucha JJ, Hermans JE, Therneau TM, Dickson ER, Evans RW et al. Cost-effectiveness of 6 and 12 months of interferon-α therapy for chronic hepatitis C. Annals of Internal Medicine. 1997 Nov 15;127(10):866-874.
Kim, W. Ray ; Poterucha, John J. ; Hermans, John E. ; Therneau, Terry M ; Dickson, E. Rolland ; Evans, Roger W. ; Gross, John B. / Cost-effectiveness of 6 and 12 months of interferon-α therapy for chronic hepatitis C. In: Annals of Internal Medicine. 1997 ; Vol. 127, No. 10. pp. 866-874.
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