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COST-EFFECTIVENESS STUDY OF TREATMENT IN PATIENTS WITH
CHRONIC HEPATITIS C Objectives.
Chronic active hepatitis C is an important public health issue
because of its prevalence, evolution, and overall cost. Treatment
by recombinant alpha-interferon is both expensive and exacting and
its effectiveness is limited. We report the results of a
cost-effectiveness analysis of alpha-interferon treatment in
patients with chronic active hepatitis C.
Methods.
Direct medical costs of caring for patients with chronic active
hepatitis C and its complications, based on treatment of no
treatment, were assessed with retrospective data collected from the
files of 137 hospital patients. Seventy-seven patients were treated
with alpha-interferon between 1988 and 1994. The overall costs of
caring for chronic active hepatitis C (3 millions units three times
a week) for 6 months (strategy A), 12 months (strategy B), or 12
months but discontinuing treatment when there was no response
(strategy C), was reported and compared to the respective
effectiveness of each.
Results.
With an actualization rate of 5%, the real overall cost of caring
for a chronic active hepatitis C patient was 143 290 FF.
Considering the contraindication rate (15%), the treatment
acceptance (85%), the response rate to treatment (50%), and the
prolonged response rate (25 to 30%), treating patients with
strategy A induced a real overall cost of caring to 140 731 FF to
avoid 0.11 cases of cirrhosis, to 150 277 FF to avoid 0.13 cases of
cirrhosis with strategy B, and to 136 947 FF to avoid 0.13 cases of
cirrhosis with strategy C.
Conclusion.
Alpha-interferon treatment in patients with chronic active
hepatitis C provides a long-term saving compared to cases which
receive no treatment. Strategy C was the most cost-effective,
inducing the reduction of both the number of cases of cirrhosis and
the cost of care.
Author: JOLIOT E, CHU BESANCON, SERV HEPATOL, F-25030
BESANCON, FRANCE
Source: GASTROENTEROLOGIE CLINIQUE ET BIOLOGIQUE 1996
NOV;20(11):958-967
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