Cost effectiveness of peginterferon α-2b plus ribavirin versus interferon α-2b plus ribavirin for initial treatment of chronic hepatitis C

U. Siebert, G. Sroczynski, S. Rossol, J. Wasem, U. Ravens-Sieberer, B. M. Kurth, M. P. Manns, J. G. McHutchison, J. B. Wong, W. Greiner, J. M G vonderSchulenburg, M. Bullinger, P. Aidelsburger, F. Hessel, F. Buchner, M. Corzillius, F. H. Anderson, S. Arora, B. Bacon, L. BalartK. G. Benner, M. A. Bigard, H. C. Bodenheimer, M. Bourliere, C. Brechot, H. Brunner, S. Caldwell, W. Carey, R. L. Carithers, G. L. Davis, J. Dienstag, J. Donovan, R. Esteban-Mur, M. Buti, G. T. Everson, S. Feinman, S. Flamm, P. R. Galle, R. Gish, N. Gitlin, T. Goeser, S. Gordon, H. Greten, S. Hadzyiannis, I. Hokeberg, I. Jacobson, P. Kwo, D. R. LaBrecque, W. M. Lee, S. Lindgren, K. L. Lindsay, M. P. Manns, P. Marcellin, P. Marotta, T. McGarrity, J. G. McHutchison, R. Moreno, T. R. Morgan, R. Perrillo, M. Poliquin, T. Poynard, J. Rakela, R. Reindollar, J. L. Rodriguez-Agullo, R. Rouzier-Panis, V. Rustgi, J. M. Sanchez-Tapias, E. R. Schiff, D. Schuppan, M. Sherman, M. L. Shiffman, M. Silva, C. Smith, H. Tanno, C. Trepo, W. Vogel, T. Wright, S. Zeuzem

Research output: Contribution to journalArticle

187 Citations (Scopus)

Abstract

Background: Peginterferon α-2b plus ribavirin therapy in previously untreated patients with chronic hepatitis C yields the highest sustained virological response rates of any treatment strategy but is expensive. Aims: To estimate the cost effectiveness of treatment with peginterferon α-2b plus ribavirin compared with interferon α-2b plus ribavirin for initial treatment of patients with chronic hepatitis C. Methods: Individual patient level data from a randomised clinical trial with peginterferon plus ribavirin were applied to a previously published and validated Markov model to project lifelong clinical outcomes. Quality of life and economic estimates were based on German patient data. We used a societal perspective and applied a 3% annual discount rate. Results: Compared with no antiviral therapy, peginterferon plus fixed or weight based dosing of ribavirin increased life expectancy by 4.2 and 4.7 years, respectively. Compared with standard interferon α-2b plus ribavirin, peginterferon plus fixed or weight based dosing of ribavirin increased life expectancy by 0.5 and by 1.0 years with incremental cost effectiveness ratios of €11 800 and €6600 per quality adjusted life year (QALY), respectively. Subgroup analyses by genotype, viral load, sex, and histology showed that peginterferon plus weight based ribavirin remained cost effective compared with other well accepted medical treatments. Conclusions: Peginterferon α-2b plus ribavirin should reduce the incidence of liver complications, prolong life, improve quality of life, and be cost effective for the initial treatment of chronic hepatitis C.

Original languageEnglish
Pages (from-to)425-432
Number of pages8
JournalGut
Volume52
Issue number3
DOIs
StatePublished - Mar 1 2003

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Ribavirin
Chronic Hepatitis C
Interferons
Cost-Benefit Analysis
Therapeutics
Quality of Life
Life Expectancy
Weights and Measures
Costs and Cost Analysis
Quality-Adjusted Life Years
Viral Load
Antiviral Agents
Histology
Randomized Controlled Trials
Genotype
Economics
Liver
Incidence

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Siebert, U., Sroczynski, G., Rossol, S., Wasem, J., Ravens-Sieberer, U., Kurth, B. M., ... Zeuzem, S. (2003). Cost effectiveness of peginterferon α-2b plus ribavirin versus interferon α-2b plus ribavirin for initial treatment of chronic hepatitis C. Gut, 52(3), 425-432. https://doi.org/10.1136/gut.52.3.425

Cost effectiveness of peginterferon α-2b plus ribavirin versus interferon α-2b plus ribavirin for initial treatment of chronic hepatitis C. / Siebert, U.; Sroczynski, G.; Rossol, S.; Wasem, J.; Ravens-Sieberer, U.; Kurth, B. M.; Manns, M. P.; McHutchison, J. G.; Wong, J. B.; Greiner, W.; vonderSchulenburg, J. M G; Bullinger, M.; Aidelsburger, P.; Hessel, F.; Buchner, F.; Corzillius, M.; Anderson, F. H.; Arora, S.; Bacon, B.; Balart, L.; Benner, K. G.; Bigard, M. A.; Bodenheimer, H. C.; Bourliere, M.; Brechot, C.; Brunner, H.; Caldwell, S.; Carey, W.; Carithers, R. L.; Davis, G. L.; Dienstag, J.; Donovan, J.; Esteban-Mur, R.; Buti, M.; Everson, G. T.; Feinman, S.; Flamm, S.; Galle, P. R.; Gish, R.; Gitlin, N.; Goeser, T.; Gordon, S.; Greten, H.; Hadzyiannis, S.; Hokeberg, I.; Jacobson, I.; Kwo, P.; LaBrecque, D. R.; Lee, W. M.; Lindgren, S.; Lindsay, K. L.; Manns, M. P.; Marcellin, P.; Marotta, P.; McGarrity, T.; McHutchison, J. G.; Moreno, R.; Morgan, T. R.; Perrillo, R.; Poliquin, M.; Poynard, T.; Rakela, J.; Reindollar, R.; Rodriguez-Agullo, J. L.; Rouzier-Panis, R.; Rustgi, V.; Sanchez-Tapias, J. M.; Schiff, E. R.; Schuppan, D.; Sherman, M.; Shiffman, M. L.; Silva, M.; Smith, C.; Tanno, H.; Trepo, C.; Vogel, W.; Wright, T.; Zeuzem, S.

In: Gut, Vol. 52, No. 3, 01.03.2003, p. 425-432.

Research output: Contribution to journalArticle

Siebert, U, Sroczynski, G, Rossol, S, Wasem, J, Ravens-Sieberer, U, Kurth, BM, Manns, MP, McHutchison, JG, Wong, JB, Greiner, W, vonderSchulenburg, JMG, Bullinger, M, Aidelsburger, P, Hessel, F, Buchner, F, Corzillius, M, Anderson, FH, Arora, S, Bacon, B, Balart, L, Benner, KG, Bigard, MA, Bodenheimer, HC, Bourliere, M, Brechot, C, Brunner, H, Caldwell, S, Carey, W, Carithers, RL, Davis, GL, Dienstag, J, Donovan, J, Esteban-Mur, R, Buti, M, Everson, GT, Feinman, S, Flamm, S, Galle, PR, Gish, R, Gitlin, N, Goeser, T, Gordon, S, Greten, H, Hadzyiannis, S, Hokeberg, I, Jacobson, I, Kwo, P, LaBrecque, DR, Lee, WM, Lindgren, S, Lindsay, KL, Manns, MP, Marcellin, P, Marotta, P, McGarrity, T, McHutchison, JG, Moreno, R, Morgan, TR, Perrillo, R, Poliquin, M, Poynard, T, Rakela, J, Reindollar, R, Rodriguez-Agullo, JL, Rouzier-Panis, R, Rustgi, V, Sanchez-Tapias, JM, Schiff, ER, Schuppan, D, Sherman, M, Shiffman, ML, Silva, M, Smith, C, Tanno, H, Trepo, C, Vogel, W, Wright, T & Zeuzem, S 2003, 'Cost effectiveness of peginterferon α-2b plus ribavirin versus interferon α-2b plus ribavirin for initial treatment of chronic hepatitis C', Gut, vol. 52, no. 3, pp. 425-432. https://doi.org/10.1136/gut.52.3.425
Siebert, U. ; Sroczynski, G. ; Rossol, S. ; Wasem, J. ; Ravens-Sieberer, U. ; Kurth, B. M. ; Manns, M. P. ; McHutchison, J. G. ; Wong, J. B. ; Greiner, W. ; vonderSchulenburg, J. M G ; Bullinger, M. ; Aidelsburger, P. ; Hessel, F. ; Buchner, F. ; Corzillius, M. ; Anderson, F. H. ; Arora, S. ; Bacon, B. ; Balart, L. ; Benner, K. G. ; Bigard, M. A. ; Bodenheimer, H. C. ; Bourliere, M. ; Brechot, C. ; Brunner, H. ; Caldwell, S. ; Carey, W. ; Carithers, R. L. ; Davis, G. L. ; Dienstag, J. ; Donovan, J. ; Esteban-Mur, R. ; Buti, M. ; Everson, G. T. ; Feinman, S. ; Flamm, S. ; Galle, P. R. ; Gish, R. ; Gitlin, N. ; Goeser, T. ; Gordon, S. ; Greten, H. ; Hadzyiannis, S. ; Hokeberg, I. ; Jacobson, I. ; Kwo, P. ; LaBrecque, D. R. ; Lee, W. M. ; Lindgren, S. ; Lindsay, K. L. ; Manns, M. P. ; Marcellin, P. ; Marotta, P. ; McGarrity, T. ; McHutchison, J. G. ; Moreno, R. ; Morgan, T. R. ; Perrillo, R. ; Poliquin, M. ; Poynard, T. ; Rakela, J. ; Reindollar, R. ; Rodriguez-Agullo, J. L. ; Rouzier-Panis, R. ; Rustgi, V. ; Sanchez-Tapias, J. M. ; Schiff, E. R. ; Schuppan, D. ; Sherman, M. ; Shiffman, M. L. ; Silva, M. ; Smith, C. ; Tanno, H. ; Trepo, C. ; Vogel, W. ; Wright, T. ; Zeuzem, S. / Cost effectiveness of peginterferon α-2b plus ribavirin versus interferon α-2b plus ribavirin for initial treatment of chronic hepatitis C. In: Gut. 2003 ; Vol. 52, No. 3. pp. 425-432.
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abstract = "Background: Peginterferon α-2b plus ribavirin therapy in previously untreated patients with chronic hepatitis C yields the highest sustained virological response rates of any treatment strategy but is expensive. Aims: To estimate the cost effectiveness of treatment with peginterferon α-2b plus ribavirin compared with interferon α-2b plus ribavirin for initial treatment of patients with chronic hepatitis C. Methods: Individual patient level data from a randomised clinical trial with peginterferon plus ribavirin were applied to a previously published and validated Markov model to project lifelong clinical outcomes. Quality of life and economic estimates were based on German patient data. We used a societal perspective and applied a 3{\%} annual discount rate. Results: Compared with no antiviral therapy, peginterferon plus fixed or weight based dosing of ribavirin increased life expectancy by 4.2 and 4.7 years, respectively. Compared with standard interferon α-2b plus ribavirin, peginterferon plus fixed or weight based dosing of ribavirin increased life expectancy by 0.5 and by 1.0 years with incremental cost effectiveness ratios of €11 800 and €6600 per quality adjusted life year (QALY), respectively. Subgroup analyses by genotype, viral load, sex, and histology showed that peginterferon plus weight based ribavirin remained cost effective compared with other well accepted medical treatments. Conclusions: Peginterferon α-2b plus ribavirin should reduce the incidence of liver complications, prolong life, improve quality of life, and be cost effective for the initial treatment of chronic hepatitis C.",
author = "U. Siebert and G. Sroczynski and S. Rossol and J. Wasem and U. Ravens-Sieberer and Kurth, {B. M.} and Manns, {M. P.} and McHutchison, {J. G.} and Wong, {J. B.} and W. Greiner and vonderSchulenburg, {J. M G} and M. Bullinger and P. Aidelsburger and F. Hessel and F. Buchner and M. Corzillius and Anderson, {F. H.} and S. Arora and B. Bacon and L. Balart and Benner, {K. G.} and Bigard, {M. A.} and Bodenheimer, {H. C.} and M. Bourliere and C. Brechot and H. Brunner and S. Caldwell and W. Carey and Carithers, {R. L.} and Davis, {G. L.} and J. Dienstag and J. Donovan and R. Esteban-Mur and M. Buti and Everson, {G. T.} and S. Feinman and S. Flamm and Galle, {P. R.} and R. Gish and N. Gitlin and T. Goeser and S. Gordon and H. Greten and S. Hadzyiannis and I. Hokeberg and I. Jacobson and P. Kwo and LaBrecque, {D. R.} and Lee, {W. M.} and S. Lindgren and Lindsay, {K. L.} and Manns, {M. P.} and P. Marcellin and P. Marotta and T. McGarrity and McHutchison, {J. G.} and R. Moreno and Morgan, {T. R.} and R. Perrillo and M. Poliquin and T. Poynard and J. Rakela and R. Reindollar and Rodriguez-Agullo, {J. L.} and R. Rouzier-Panis and V. Rustgi and Sanchez-Tapias, {J. M.} and Schiff, {E. R.} and D. Schuppan and M. Sherman and Shiffman, {M. L.} and M. Silva and C. Smith and H. Tanno and C. Trepo and W. Vogel and T. Wright and S. Zeuzem",
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TY - JOUR

T1 - Cost effectiveness of peginterferon α-2b plus ribavirin versus interferon α-2b plus ribavirin for initial treatment of chronic hepatitis C

AU - Siebert, U.

AU - Sroczynski, G.

AU - Rossol, S.

AU - Wasem, J.

AU - Ravens-Sieberer, U.

AU - Kurth, B. M.

AU - Manns, M. P.

AU - McHutchison, J. G.

AU - Wong, J. B.

AU - Greiner, W.

AU - vonderSchulenburg, J. M G

AU - Bullinger, M.

AU - Aidelsburger, P.

AU - Hessel, F.

AU - Buchner, F.

AU - Corzillius, M.

AU - Anderson, F. H.

AU - Arora, S.

AU - Bacon, B.

AU - Balart, L.

AU - Benner, K. G.

AU - Bigard, M. A.

AU - Bodenheimer, H. C.

AU - Bourliere, M.

AU - Brechot, C.

AU - Brunner, H.

AU - Caldwell, S.

AU - Carey, W.

AU - Carithers, R. L.

AU - Davis, G. L.

AU - Dienstag, J.

AU - Donovan, J.

AU - Esteban-Mur, R.

AU - Buti, M.

AU - Everson, G. T.

AU - Feinman, S.

AU - Flamm, S.

AU - Galle, P. R.

AU - Gish, R.

AU - Gitlin, N.

AU - Goeser, T.

AU - Gordon, S.

AU - Greten, H.

AU - Hadzyiannis, S.

AU - Hokeberg, I.

AU - Jacobson, I.

AU - Kwo, P.

AU - LaBrecque, D. R.

AU - Lee, W. M.

AU - Lindgren, S.

AU - Lindsay, K. L.

AU - Manns, M. P.

AU - Marcellin, P.

AU - Marotta, P.

AU - McGarrity, T.

AU - McHutchison, J. G.

AU - Moreno, R.

AU - Morgan, T. R.

AU - Perrillo, R.

AU - Poliquin, M.

AU - Poynard, T.

AU - Rakela, J.

AU - Reindollar, R.

AU - Rodriguez-Agullo, J. L.

AU - Rouzier-Panis, R.

AU - Rustgi, V.

AU - Sanchez-Tapias, J. M.

AU - Schiff, E. R.

AU - Schuppan, D.

AU - Sherman, M.

AU - Shiffman, M. L.

AU - Silva, M.

AU - Smith, C.

AU - Tanno, H.

AU - Trepo, C.

AU - Vogel, W.

AU - Wright, T.

AU - Zeuzem, S.

PY - 2003/3/1

Y1 - 2003/3/1

N2 - Background: Peginterferon α-2b plus ribavirin therapy in previously untreated patients with chronic hepatitis C yields the highest sustained virological response rates of any treatment strategy but is expensive. Aims: To estimate the cost effectiveness of treatment with peginterferon α-2b plus ribavirin compared with interferon α-2b plus ribavirin for initial treatment of patients with chronic hepatitis C. Methods: Individual patient level data from a randomised clinical trial with peginterferon plus ribavirin were applied to a previously published and validated Markov model to project lifelong clinical outcomes. Quality of life and economic estimates were based on German patient data. We used a societal perspective and applied a 3% annual discount rate. Results: Compared with no antiviral therapy, peginterferon plus fixed or weight based dosing of ribavirin increased life expectancy by 4.2 and 4.7 years, respectively. Compared with standard interferon α-2b plus ribavirin, peginterferon plus fixed or weight based dosing of ribavirin increased life expectancy by 0.5 and by 1.0 years with incremental cost effectiveness ratios of €11 800 and €6600 per quality adjusted life year (QALY), respectively. Subgroup analyses by genotype, viral load, sex, and histology showed that peginterferon plus weight based ribavirin remained cost effective compared with other well accepted medical treatments. Conclusions: Peginterferon α-2b plus ribavirin should reduce the incidence of liver complications, prolong life, improve quality of life, and be cost effective for the initial treatment of chronic hepatitis C.

AB - Background: Peginterferon α-2b plus ribavirin therapy in previously untreated patients with chronic hepatitis C yields the highest sustained virological response rates of any treatment strategy but is expensive. Aims: To estimate the cost effectiveness of treatment with peginterferon α-2b plus ribavirin compared with interferon α-2b plus ribavirin for initial treatment of patients with chronic hepatitis C. Methods: Individual patient level data from a randomised clinical trial with peginterferon plus ribavirin were applied to a previously published and validated Markov model to project lifelong clinical outcomes. Quality of life and economic estimates were based on German patient data. We used a societal perspective and applied a 3% annual discount rate. Results: Compared with no antiviral therapy, peginterferon plus fixed or weight based dosing of ribavirin increased life expectancy by 4.2 and 4.7 years, respectively. Compared with standard interferon α-2b plus ribavirin, peginterferon plus fixed or weight based dosing of ribavirin increased life expectancy by 0.5 and by 1.0 years with incremental cost effectiveness ratios of €11 800 and €6600 per quality adjusted life year (QALY), respectively. Subgroup analyses by genotype, viral load, sex, and histology showed that peginterferon plus weight based ribavirin remained cost effective compared with other well accepted medical treatments. Conclusions: Peginterferon α-2b plus ribavirin should reduce the incidence of liver complications, prolong life, improve quality of life, and be cost effective for the initial treatment of chronic hepatitis C.

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