| Autor: |
Shiell, Alan, Brown, Sue, Farrell, Geoff C |
| Zdroj: |
Medical Journal of Australia; August 1999, Vol. 171 Issue: 4 p189-193, 5p |
| Abstrakt: |
Objectives:To re‐evaluate the cost effectiveness of treating hepatitis C virus (HCV) infection with interferon alfa (IFα) in Australia, taking into account changes in clinical practice. Design:A decision‐analytic method (Markov model) was used to simulate the costs and effects of 6 months and 12 months of treatment with IFα versus no treatment (conventional management). Both costs and effects were modelled over 30 years. Data sources:Published meta‐analysis of the effectiveness of treatment, professional judgement about treatment protocols, scheduled medical fees, diagnosis‐related costs for hospital admission, and a literature search for quality‐of‐life weights. Patients:A hypothetical cohort of 1000 patients with chronic HCV infection aged 40 years at the start of treatment. Main outcome measures:Incremental costs per life‐year gained and per quality‐adjusted life‐year (QALY) gained. Results:Compared with no treatment, IFα treatment for 6 months results in an extra 94.2 life‐years or 320.1 QALYs at an extra cost of $1.8 million (after discounting at 3%) in a cohort of 1000 patients. Discounted cost per life‐year gained is $19110, which is about a quarter of the cost reported in 1994. The discounted cost per QALY gained is $5625. Extended treatment for another 6 months results in an additional 89.0 life‐years saved or 170.8 QALYs gained at an incremental discounted cost of $15835 per life‐year gained and $8250 per QALY gained. Conclusions:The cost effectiveness of IFα treatment for HCV infection has improved as a result of better patient selection, cost reductions and enhanced effectiveness of extended treatment. The results are sensitive to assumptions made about quality of life and the discount rate. |
| Databáze: |
Supplemental Index |
| Externí odkaz: |
|
Plný text