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

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.