Clinical- and cost-effectiveness of pegylated interferon alfa in the treatment of chronic hepatitis C: a systematic review and economic evaluation.

摘要: Objectives: To assess the clinical-effectiveness and cost-effectiveness of pegylated interferon alfa (2a 2b) combined with ribavirin in previously untreated patients moderate to severe chronic hepatitis C, compared current standard treatment, which is nonpegylated ribavirin. Methods: Systematic review economic evaluation. A sensitive search strategy was applied several electronic bibliographic databases. Relevant studies were critically appraised meta-analyzed. hypothetical cohort 1,000 entered a Markov model followed up for more than 30-year period predict natural history, duration spent each health state, treatment costs. Results: Two fully published Phase III randomized controlled trials included. Methodological quality generally good. Dual therapy significantly effective dual pooled sustained virological response rate (SVR) 55 percent (95 confidence interval [CI], 52–58 percent) 46 CI, 43–49 percent). The relative risk remaining infected 0.83 0.76–0.91 Genotype strongest predictor outcome, SVRs responsive genotypes 2 3 reaching 80 percent. incremental cost per quality-adjusted life year (QALY) £12,123. QALY remained under £30,000 most patient subgroups sensitivity analyses. Conclusions: Pegylated clinically effective, represents good value money, significant advance this insidious disease.