AN ECONOMIC-EVALUATION OF THE COSTS OF ALPHA-INTERFERON TREATMENT OF CHRONIC ACTIVE HEPATITIS DUE TO HEPATITIS-B OR HEPATITIS-C VIRUS

An economic evaluation to compare the costs of care and likely outcome for patients treated with alpha-interferon for chronic active hepatitis B and C was performed. As complete prospective data are not available, we have made comparisons between two cohorts of 100 hypothetical patients. Treatment of chronic hepatitis B would be with alpha-interferon at an average dose of 9 million units three times per week for 16 weeks. Chronic active hepatitis C treatment is based on a dose of 3 million units three times weekly for a total of 6 months. In untreated patients with chronic active hepatitis B or C, the risk of developing cirrhosis is considered to be 10-20% in a 10-year period. Patterns of good practice are costed using typical costs of patients in our institution. These costs are aggregated using the probabilities of morbidity and mortality, from therapeutic and epidemiological studies, for patients developing cirrhosis. A sensitivity analysis has been applied to the results. If we assume a latency period of 10 years, the costs of a successfully treated patient with both hepatitis B and C will be recouped. For hepatitis C, benefits are apparent when social costs are are added, the price of alpha-interferon is reduced by 10% and the response rate raised by 20%. Nevertheless, if morbidity effects and costs to patients are included, the advantages of treatment are more apparent, with potential savings in both chronic hepatitis B and C. The model we have developed can be adapted as firmer evidence becomes available.