Durham, NC, USA – A shortened regimen of anti-viral treatment may be cost-effective for patients with chronic hepatitis C, according to a study by Duke Clinical Research Institute researchers in Durham, North Carolina.
Using a decision model that compared standard duration therapy and response-guided therapy, the researchers found that response-guided therapy led to an average of $4,263 decrease in lifetime costs without sacrificing treatment efficacy.
Prior to the introduction of protease inhibitors, U.S. guidelines recommended treatment duration based on hepatitis C genotype — 48 weeks of pegylated interferon and ribavirin for patients with genotype 1 and 4 and 24 weeks in patients with genotypes 2 and 3. In Europe however, practice guidelines recommend using response-guided therapy, in which treatment duration can be cut in half for select patients who achieve a rapid virologic response.
“Rapid virologic response, defined as undetectable viral level at week four of treatment, is emerging as an important marker in the treatment of hepatitis C.” said Ziad F. Gellad, M.D., M.P.H., assistant professor of medicine at Duke, and first author of the study, “Cost-Effectiveness of Truncated Therapy for Hepatitis C Based on Rapid Virologic Response.” While new drugs have recently been approved in the United States and Europe for genotype 1, interferon-based dual therapy remains the mainstay of treatment for millions of individuals affected by this disease.
Although the proportion of patients qualifying for shortened therapy was small – only 18 percent – their rate of sustained virologic response was greater than 80 percent. Gellad goes on to state, “For every 10 patients undergoing response-guided therapy, the savings accrued could be used to pay for an additional 48 weeks of antiviral treatment.” Additional clinical trials should be conducted to confirm the safety and effectiveness of response-guided therapy.
This study is published in Value in Health, the official journal of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR).
Value in Health (ISSN 1098-3015) publishes papers, concepts, and ideas that advance the field of pharmacoeconomics and outcomes research as well as policy papers to help health care leaders make evidence-based decisions. The journal is published bi-monthly and has over 8,000 subscribers (clinicians, decision-makers, and researchers worldwide).
International Society for Pharmacoeconomics and Outcomes Research (ISPOR) is a nonprofit, international, educational and scientific organization that strives to increase the efficiency, effectiveness, and fairness of health care resource use to improve health.
For more information: www.ispor.org