Review of cost–effectiveness studies of pegylated therapies for hepatitis C

Abstract

Hepatitis C virus is a worldwide public health problem and carries an increased economic burden that affects individuals, employers, insurers and health systems. Estimates suggest that by the year 2008, the yearly costs of hepatitis C virus will exceed US$1 billion. The authors conducted a literature search to identify studies on pharmacoeconomics and outcomes research for hepatitis C virus. According to the literature, the new standard for disease management is interferon-α, chemically linked with polyethylene glycol (pegylated interferon-α) as a monotherapy, or in combination with ribavirin. The authors reviewed a number of articles providing original research on outcomes related to pegylated therapies. Clinical outcomes and end points included sustained and early virologic response, disease progression, liver complications and mortality; economic outcomes included direct medical costs related to in- and outpatient costs, screening and diagnostics. Studies that consider health-related quality of life and fatigue were also identified. While most of the studies adopted Markov modeling to predict the likely outcomes and the effects of therapy, it is also important to consider indirect costs, such as productivity loss related to absenteeism. Future research on the use of pegylated interferons, weight-adjusted dosing of ribavirin, and the treatment of relapsers and nonresponders should provide valuable data that can be incorporated into cost–effectiveness studies.

Keywords::

• hepatitis C
• pegylated interferons
• sustained viral response
• cost–effectiveness
• economic endpoints