A systematic review of the cost–effectiveness of peginterferon alfa-2b in the treatment of chronic hepatitis C

Abstract

A systematic review was conducted of the full economic evaluations of the cost–effectiveness of peginterferon alfa-2b (PEG-IFN alfa-2b) plus ribavirin (RBV) in the treatment of chronic hepatitis C (CHC). A total of 439 references were screened and 11 studies were included. The studies employed decision analytic Markov models in which hypothetical cohorts of patients progressed through a series of health states characteristic of the natural history of CHC. The studies analyzed various regimens of PEG-IFN alfa-2b plus RBV including stopping rules for different genotypes, and fixed or weight-based dosing of RBV. In all studies, PEG-IFN alfa-2b plus RBV was associated with favorable incremental cost–effectiveness ratios (ICERs) when compared with IFN plus RBV. Tailored treatment according to bodyweight dosing and circumscribed treatment for different genotypes improves ICERs further. Further cost–effectiveness analyses should consider the impact of antiviral treatment in subgroups of patients including those co-infected with HIV, hemophiliacs and patients who are retreated following previous treatment failure, where data are available.

Keywords::

• chronic hepatitis C
• cirrhosis
• cost–effectiveness
• decision analytic modeling
• IFN-α
• pegylated IFN-α2b
• systematic review

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.