Economic analysis of recombinant interferon α 2b in the treatment of chronic hepatitis B and C

Yao Guangbi, Wang Baoen
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Abstract

OBJECTIVE: To evaluate the long-term economic impact and benefits of interferon α 2b (IFNα 2b) treatment in patients with chronic hepatitis B and C. METHODS: Data from 6500 patients with chronic hepatitis B and C from 12 teaching hospitals in different areas of China were collected and analyzed. Cohorts of these patients with either chronic hepatitis B (2198 cases) or chronic hepatitis C (756 cases) that were treated with IFNα 2b were compared with a non-IFN- treated cohort (B, 2642 cases; C, 904 cases). Data from MEDLINE and Chinese Bio-Medical Database (CBMD) searches regarding the natural course of the disease, progression, efficacy and cost of IFN therapy were also included. Using a decision analysis software program, Markov computer simulation was used to estimate the progression of the disease and perform economic analyses. RESULTS: The 30-year disease progression to compensated and uncompensated cirrhosis and hepatocellular carcinoma in both chronic hepatitis B and C in the IFN-treated cohort was significantly decreased in comparison with the non-IFN-treated cohort. The results suggest that IFN treatment could increase life expectancy by 5.32 years in chronic hepatitis B and 4.06 years in chronic hepatitis C. In the IFN-treated group, life expectancy would increase by 5.41 and 4.27 quality-adjusted life-years (QALY), respectively. The cost to increase life expectancy by 1 QALY could be reduced by 5180 or 9066 yuan RMB in chronic hepatitis B or C patients treated with IFNα 2b, respectively. Over a 30-year period, the total direct medical costs would be reduced by 42 820 and 65 440 yuan RMB in chronic hepatitis B and C patients treated with IFNα 2b, respectively. CONCLUSION: Interferon α 2b therapy can prolong life expectancy, improve quality of life and lower the medical costs for patients with chronic hepatitis B and C.
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重组干扰素α 2b治疗慢性乙型和丙型肝炎的经济分析
目的:评价干扰素α 2b (IFNα 2b)治疗慢性乙型和丙型肝炎患者的长期经济影响和获益。方法:收集和分析来自中国不同地区12家教学医院的6500例慢性乙型和丙型肝炎患者的数据。接受IFNα 2b治疗的慢性乙型肝炎(2198例)或慢性丙型肝炎(756例)患者的队列与未接受ifn治疗的队列(B, 2642例;C, 904例)。从MEDLINE和中国生物医学数据库(CBMD)搜索的有关疾病自然过程、进展、IFN治疗的疗效和成本的数据也被纳入。使用决策分析软件程序,马尔可夫计算机模拟用于估计疾病的进展并进行经济分析。结果:与非ifn治疗组相比,ifn治疗组慢性乙型和丙型肝炎患者30年的代偿性和非代偿性肝硬化和肝细胞癌的疾病进展显著降低。结果表明,干扰素治疗可使慢性乙型肝炎患者的预期寿命增加5.32年,慢性丙型肝炎患者的预期寿命增加4.06年。干扰素治疗组的预期寿命分别增加5.41年和4.27年质量调整生命年(QALY)。慢性乙型肝炎和丙型肝炎患者接受IFNα 2b治疗后,预期寿命每增加1个QALY可分别降低5180元和9066元人民币。在30年的时间里,使用IFNα 2b治疗慢性乙型肝炎和丙型肝炎患者的直接医疗费用总额分别减少42 820元和65 440元。结论:干扰素α 2b治疗可延长慢性乙型和丙型肝炎患者的预期寿命,提高生活质量,降低医疗费用。
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