### Acta Gastroenterol Belg. 2004 Jan-Mar;67(1):1-8. Related Articles, Links

A health economic model to assess the long term effects and cost-effectiveness
of PEG IFN alpha-2a in hepatitis C virus infected patients.

### Annemans L, Warie H, Nechelput M, Peraux B.

HEDM, Meise, Belgium. lieven.annemans@hedm.be

OBJECTIVES: Chronic Hepatitis C (CHC) is associated with long-term complications.
Treating CHC with Pegylated interferon alpha-2a (PEG IFN alpha-2a) improves
response rates and may contribute to less morbidity and mortality compared to
standard interferon therapy. The objectives of this study were to estimate the
long-term clinical consequences of such treatment as well as the resulting cost-effectiveness.
RESEARCH DESIGN AND METHODS: A Markov model was developed in order to predict
the clinical and economic outcomes over a 25 year period. Three analyses were
conducted: 1. for all Hepatitis C Virus (HCV) genotypes where PEG IFN alpha-2a
was compared to interferon alpha-2a (IFN alpha-2a) in monotherapy for 48 weeks;
2. for the HCV genotypes 1-4-5-6 comparing PEG IFN alpha-2a with interferon
alpha-2b (IFN alpha-2b) both combined with ribavirin 1000/1200 mg for 48 weeks;
and 3, where PEG IFN alpha-2a with 800 mg ribavirin was compared to IFN alpha-2b
with ribavirin 1000/1200 mg for 24 weeks in genotypes 2 and 3. RESULTS: In analysis
one the cost-effectiveness of PEG IFN alpha-2a is 4,569/quality adjusted life
year (QALY) gained. In the second analysis, the result was 14,763 euros/QALY,
while for the 24 weeks therapy (analysis 3) the result was 903 per QALY gained.
In an extensive sensitivity analysis cost-effectiveness was confirmed within
reasonable assumptions. CONCLUSIONS: These results suggest that PEG IFN alpha-2a
is cost-effective in the management of all CHC patients. Real life evidence
about longer term benefits of PEG IFN alpha-2a will be of importance for future
decision making.