A systematic review of the cost-effectiveness of peginterferon alfa-2b in the treatment of chronic hepatitis C

A systematic review was conducted of the full economic evaluations of the cost-effectiveness of peginterferon alfa-2b (PEG-IFN alfa-2b) plus ribavirin (RBV) in the treatment of chronic hepatitis C (CHC). A total of 439 references were screened and 11 studies were included. The studies employed decision analytic Markov models in which hypothetical cohorts of patients progressed through a series of health states characteristic of the natural history of CHC. The studies analyzed various regimens of PEG-IFN alfa-2b plus RBV including stopping rules for different genotypes, and fixed or weight-based dosing of RBV. In all studies, PEG-IFN alfa-2b plus RBV was associated with favorable incremental cost-effectiveness ratios (ICERs) when compared with IFN plus RBV. Tailored treatment according to bodyweight dosing and circumscribed treatment for different genotypes improves ICERs further. Further cost-effectiveness analyses should consider the impact of antiviral treatment in subgroups of patients including those co-infected with HIV, hemophiliacs and patients who are retreated following previous treatment failure, where data are available