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Cost-effectiveness of truncated therapy for hepatitis C based on rapid virologic response

Show simple item record Gellad Z.F. Muir A.J. McHutchison J.G. Sievert W. Sharara A.I. Brown K.A. Flisiak R. Jacobson I.M. Kershenobich D. Manns M.P. Schulman K.A. Reed S.D.
dc.contributor.editor Sep-2012 2017-10-05T15:38:09Z 2017-10-05T15:38:09Z 2012
dc.identifier 10.1016/j.jval.2012.06.010
dc.identifier.issn 10983015
dc.description.abstract Background: Shortened courses of treatment with pegylated interferon alfa and ribavirin for patients with hepatitis C virus infection who experience rapid virologic response can be effective in appropriately selected patients. The cost-effectiveness of truncated therapy is not known. Objective: To assess the cost-effectiveness of response-guided therapy versus standard-duration therapy on the basis of best available evidence. Methods: We developed a decision model for chronic hepatitis C virus infection representing two treatment strategies: 1) standard-duration therapy with pegylated interferon alfa and ribavirin for 48 weeks in patients with genotype 1 or 4 and for 24 weeks in patients with genotype 2 or 3 and 2) truncated therapy (i.e., 50percent decrease in treatment duration) in patients with rapid virologic response. Patients for whom truncated therapy failed began standard-duration therapy guided by genotype. We used a Markov model to estimate lifetime costs and quality-adjusted life-years. Results: In the base-case analysis, mean lifetime costs were $46,623 ± $2,483 with standard-duration therapy and $42,354 ± $2,489 with truncated therapy. Mean lifetime quality-adjusted life-years were similar between the groups (17.1 ± 0.7 with standard therapy; 17.2 ± 0.7 with truncated therapy). Across model simulations, the probability of truncated therapy being economically dominant (i.e., both cost saving and more effective) was 78.6percent. The results were consistent when we stratified the data by genotype. In one-way sensitivity analyses, the results were sensitive only to changes in treatment efficacy. Conclusion: Truncated therapy based on rapid virologic response is likely to be cost saving for treatment-naive patients with chronic hepatitis C virus infection. Cost-effectiveness varied with small changes in relative treatment efficacy. © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR).
dc.format.extent Pages: (876-886)
dc.language English
dc.publisher NEW YORK
dc.relation.ispartof Publication Name: Value in Health; Publication Year: 2012; Volume: 15; no. 6; Pages: (876-886);
dc.source Scopus
dc.title Cost-effectiveness of truncated therapy for hepatitis C based on rapid virologic response
dc.type Article
dc.contributor.affiliation Gellad, Z.F., Duke Clinical Research Institute, Duke University School of Medicine, PO Box 17969, Durham, NC 27715, United States, Department of Medicine, Duke University School of Medicine, Durham, NC, United States, Durham Veterans Affairs Medical Center, Durham, NC, United States
dc.contributor.affiliation Muir, A.J., Duke Clinical Research Institute, Duke University School of Medicine, PO Box 17969, Durham, NC 27715, United States, Department of Medicine, Duke University School of Medicine, Durham, NC, United States
dc.contributor.affiliation McHutchison, J.G., Gilead Pharmaceuticals, Foster City, CA, United States
dc.contributor.affiliation Sievert, W., Monash Medical Centre, Monash University, Melbourne, Australia
dc.contributor.affiliation Sharara, A.I., American University of Beirut Medical Center, Beirut, Lebanon
dc.contributor.affiliation Brown, K.A., Henry Ford Hospital, Detroit, MI, United States
dc.contributor.affiliation Flisiak, R., Medical University of Bialystok, Bialystok, Poland
dc.contributor.affiliation Jacobson, I.M., Weill Cornell Medical College, New York, NY, United States
dc.contributor.affiliation Kershenobich, D., Universidad Nacional Autónoma de México, Hospital General de México, Mexico City, Mexico
dc.contributor.affiliation Manns, M.P., Medical School of Hannover, Hannover, Germany
dc.contributor.affiliation Schulman, K.A., Duke Clinical Research Institute, Duke University School of Medicine, PO Box 17969, Durham, NC 27715, United States, Department of Medicine, Duke University School of Medicine, Durham, NC, United States
dc.contributor.affiliation Reed, S.D., Duke Clinical Research Institute, Duke University School of Medicine, PO Box 17969, Durham, NC 27715, United States, Department of Medicine, Duke University School of Medicine, Durham, NC, United States
dc.contributor.authorAddress Gellad, Z.F.; Duke Clinical Research Institute, Duke University School of Medicine, PO Box 17969, Durham, NC 27715, United States; email:
dc.contributor.authorCorporate University: American University of Beirut Medical Center; Faculty: Faculty of Medicine; Department: Internal Medicine;
dc.contributor.authorDepartment Internal Medicine
dc.contributor.authorFaculty Faculty of Medicine
dc.contributor.authorInitials Gellad, ZF
dc.contributor.authorInitials Muir, AJ
dc.contributor.authorInitials McHutchison, JG
dc.contributor.authorInitials Sievert, W
dc.contributor.authorInitials Sharara, AI
dc.contributor.authorInitials Brown, KA
dc.contributor.authorInitials Flisiak, R
dc.contributor.authorInitials Jacobson, IM
dc.contributor.authorInitials Kershenobich, D
dc.contributor.authorInitials Manns, MP
dc.contributor.authorInitials Schulman, KA
dc.contributor.authorInitials Reed, SD
dc.contributor.authorReprintAddress Gellad, ZF (reprint author), Duke Univ, Sch Med, Duke Clin Res Inst, POB 17969, Durham, NC 27715 USA.
dc.contributor.authorUniversity American University of Beirut Medical Center
dc.description.cited Andriulli A, 2008, ALIMENT PHARM THER, V28, P397, DOI 10.1111-j.1365-2036.2008.03763.x; Arguedas MR, 2003, AM J GASTROENTEROL, V98, P679, DOI 10.1016-S0002-9270(02)06049-5; Arias Elizabeth, 2010, Natl Vital Stat Rep, V58, P1; Bennett WG, 1997, ANN INTERN MED, V127, P855; Blatt LM, 2000, J VIRAL HEPATITIS, V7, P196; Buti M, 2007, ALIMENT PHARM THERAP, V26, P705, DOI 10.1111-j.1365-2036.2007.03419.x; Chong CAKY, 2003, AM J GASTROENTEROL, V98, P630, DOI 10.1016-S0002-9270(02)06054-9; Dalgard O, 2008, HEPATOLOGY, V47, P35, DOI 10.1002-hep.21975; Dienstag JL, 2006, GASTROENTEROLOGY, V130, P231, DOI 10.1053-j.gastro.2005.11.010; El-Serag HB, 2000, AM J GASTROENTEROL, V95, P3566; El-Zayadi AR, 2005, AM J GASTROENTEROL, V100, P2447, DOI 10.1111-j.1572-0241.2005.00253.x; European Association for the Study of the Liver, 2011, J HEPATOL, V55, P245, DOI DOI 10.1016-J.JHEP.2011.02.023]; Fattovich G, 1997, GASTROENTEROLOGY, V112, P463, DOI 10.1053-gast.1997.v112.pm9024300; Ferenci P, 2008, GASTROENTEROLOGY, V135, P451, DOI 10.1053-j.gastro.2008.04.015; Ferenci P, 2010, GASTROENTEROLOGY, V138, P503, DOI 10.1053-j.gastro.2009.10.058; Garcia-Pagan JC, 2010, NEW ENGL J MED, V362, P2370, DOI 10.1056-NEJMoa0910102; Ge DL, 2009, NATURE, V461, P399, DOI 10.1038-nature08309; Grant WC, 2005, HEPATOLOGY, V42, P1406, DOI 10.1002-hep.20941; Guiu B, 2010, CLIN GASTROENTEROL H, V8, P986, DOI 10.1016-j.cgh.2010.07.018; Hasan F, 2004, AM J GASTROENTEROL, V99, P1733, DOI 10.1111-j.1572-0241.2004.40077.x; Hay JW, 2010, VALUE HEALTH, V13, P3, DOI 10.1111-j.1524-4733.2009.00663.x; Health Resources and Services Administration, 2008, 2008 OPTN SRTR ANN R; Jepsen P, 2010, HEPATOLOGY, V51, P1675, DOI 10.1002-hep.23500; Jou JH, 2010, DIGEST DIS SCI, V55, P3591, DOI 10.1007-s10620-010-1366-3; Kamal SM, 2005, GUT, V54, P858, DOI 10.1136-gut.2004.057182; Kamal SM, 2007, HEPATOLOGY, V46, P1732, DOI 10.1002-hep.21917; Khattab M, 2010, AM J GASTROENTEROL, V105, P1970, DOI 10.1038-ajg.2010.110; KILPE VE, 1993, TRANSPLANTATION, V56, P554, DOI 10.1097-00007890-199309000-00012; KWO PY, 2010, J GERONTOL B-PSYCHOL, V376, P705, DOI DOI 10.1016-S0140-6736(10)60934-8; Lagging M, 2008, HEPATOLOGY, V47, P1837, DOI 10.1002-hep.22253; Lau JYN, 1996, ANN INTERN MED, V124, P868; Luce BR, 1996, COST EFFECTIVENESS H; Mangia A, 2008, HEPATOLOGY, V47, P43, DOI 10.1002-hep.22061; Mangia A, 2005, NEW ENGL J MED, V352, P2609, DOI 10.1056-NEJMoa042608; Mangia A, 2009, HEPATOLOGY, V49, P358, DOI 10.1002-hep.22679; McHutchison JG, 2009, NEW ENGL J MED, V361, P580, DOI 10.1056-NEJMoa0808010; McHutchison JG, 2009, NEW ENGL J MED, V360, P1827, DOI 10.1056-NEJMoa0806104; Moreno C, 2010, J HEPATOL, V52, P25, DOI 10.1016-j.jhep.2009.10.003; Muir AJ, 2004, NEW ENGL J MED, V350, P2265, DOI 10.1056-NEJMoa032502; Nainan OV, 2006, GASTROENTEROLOGY, V131, P478, DOI 10.1053-j.gastro.2006.06.007; Nakamura J, 2007, EUR J GASTROEN HEPAT, V19, P733, DOI 10.1097-MEG.0b013e3282748f1f; Poynard T, 1997, LANCET, V349, P825, DOI 10.1016-S0140-6736(96)07642-8; Rossignol JF, 2009, GASTROENTEROLOGY, V136, P856, DOI 10.1053-j.gastro.2008.11.037; Salerno F, 2004, HEPATOLOGY, V40, P629, DOI 10.1002-hep.20364; SALERNO F, 1993, AM J GASTROENTEROL, V88, P514; Sangiovanni A, 2006, HEPATOLOGY, V43, P1303, DOI 10.1002-hep.21176; Shepard CW, 2005, LANCET INFECT DIS, V5, P558, DOI 10.1016-S1473-3099(05)70216-4; Sherman KE, 2004, ARCH INTERN MED, V164, P2377, DOI 10.1001-archinte.164.21.2377; Shiffman ML, 2007, NEW ENGL J MED, V357, P124, DOI 10.1056-NEJMoa066403; Siebert U, 2009, PHARMACOECONOMICS, V27, P341, DOI 10.2165-00019053-200927040-00006; Simon RM, 2009, J NATL CANCER I, V101, P1446, DOI 10.1093-jnci-djp335; Stinnett AA, 1998, MED DECIS MAKING, V18, pS68, DOI 10.1177-0272989X9801800209; Strader DB, 2004, HEPATOLOGY, V39, P1147, DOI 10.1002-hep.20119; Thein HH, 2008, HEPATOLOGY, V48, P418, DOI 10.1002-hep.22375; Thein HH, 2005, AM J GASTROENTEROL, V100, P643, DOI 10.1111-j.1572-0241.2005.40976.x; Thomson Reuters, 2010, RED BOOK; US Department of Health and Human Services, 2010, CURR PROC TERM CPT C; U.S. Department of Veterans Affairs, DRUG PHARM PRIC; von Wagner M, 2005, GASTROENTEROLOGY, V129, P522, DOI 10.1053-j.gastro.2005.05.008; Weinstein MC, 1996, JAMA-J AM MED ASSOC, V276, P1253, DOI 10.1001-jama.276.15.1253; Younossi ZM, 2001, AM J GASTROENTEROL, V96, P579; Zeuzem S, 2006, J HEPATOL, V44, P97, DOI 10.1016-j.jhep.2005.10.003
dc.description.citedCount 1
dc.description.citedTotWOSCount 1
dc.description.citedWOSCount 1
dc.format.extentCount 11
dc.identifier.coden VIHLF
dc.identifier.pubmedID 22999138
dc.identifier.scopusID 84866412445
dc.publisher.address 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA
dc.relation.ispartOfISOAbbr Value Health
dc.relation.ispartOfIssue 6
dc.relation.ispartofPubTitle Value in Health
dc.relation.ispartofPubTitleAbbr Value Health
dc.relation.ispartOfVolume 15
dc.source.ID WOS:000309109800014
dc.type.publication Journal
dc.subject.otherAuthKeyword chronic
dc.subject.otherAuthKeyword cost-effectiveness
dc.subject.otherAuthKeyword hepatitis C
dc.subject.otherAuthKeyword interferon alfa-2a
dc.subject.otherAuthKeyword interferon alfa-2b
dc.subject.otherAuthKeyword personalized therapy
dc.subject.otherAuthKeyword response-guided therapy
dc.subject.otherAuthKeyword ribavirin
dc.subject.otherAuthKeyword treatment outcome
dc.subject.otherChemCAS ribavirin, 36791-04-5
dc.subject.otherChemCAS Antiviral Agents
dc.subject.otherChemCAS Interferon-alpha
dc.subject.otherChemCAS Polyethylene Glycols
dc.subject.otherChemCAS Recombinant Proteins
dc.subject.otherChemCAS Ribavirin, 36791-04-5
dc.subject.otherChemCAS peginterferon alfa-2a
dc.subject.otherIndex peginterferon alpha
dc.subject.otherIndex ribavirin
dc.subject.otherIndex adult
dc.subject.otherIndex antiviral therapy
dc.subject.otherIndex article
dc.subject.otherIndex controlled study
dc.subject.otherIndex cost control
dc.subject.otherIndex cost effectiveness analysis
dc.subject.otherIndex female
dc.subject.otherIndex genotype
dc.subject.otherIndex health care cost
dc.subject.otherIndex hepatitis C
dc.subject.otherIndex hidden Markov model
dc.subject.otherIndex human
dc.subject.otherIndex major clinical study
dc.subject.otherIndex male
dc.subject.otherIndex priority journal
dc.subject.otherIndex quality adjusted life year
dc.subject.otherIndex response guided therapy
dc.subject.otherIndex sensitivity analysis
dc.subject.otherIndex treatment duration
dc.subject.otherIndex virus load
dc.subject.otherIndex Adult
dc.subject.otherIndex Antiviral Agents
dc.subject.otherIndex Comparative Effectiveness Research
dc.subject.otherIndex Cost-Benefit Analysis
dc.subject.otherIndex Drug Therapy, Combination
dc.subject.otherIndex Female
dc.subject.otherIndex Hepacivirus
dc.subject.otherIndex Hepatitis C, Chronic
dc.subject.otherIndex Humans
dc.subject.otherIndex Interferon-alpha
dc.subject.otherIndex Male
dc.subject.otherIndex Middle Aged
dc.subject.otherIndex Models, Theoretical
dc.subject.otherIndex Polyethylene Glycols
dc.subject.otherIndex Recombinant Proteins
dc.subject.otherIndex Ribavirin
dc.subject.otherIndex Treatment Outcome
dc.subject.otherIndex Young Adult
dc.subject.otherKeywordPlus ALPHA-2B PLUS RIBAVIRIN
dc.subject.otherKeywordPlus QUALITY-OF-LIFE
dc.subject.otherKeywordPlus PEGINTERFERON ALPHA-2B
dc.subject.otherKeywordPlus UNITED-STATES
dc.subject.otherKeywordPlus HEPATOCELLULAR-CARCINOMA
dc.subject.otherKeywordPlus VIRUS-INFECTION
dc.subject.otherKeywordPlus HCV GENOTYPE-2
dc.subject.otherKeywordPlus COMPENSATED CIRRHOSIS
dc.subject.otherKeywordPlus FIBROSIS PROGRESSION
dc.subject.otherKeywordPlus TREATMENT DURATION
dc.subject.otherWOS Economics
dc.subject.otherWOS Health Care Sciences and Services
dc.subject.otherWOS Health Policy and Services

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