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

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dc.contributor.author Gellad Z.F.
dc.contributor.author Muir A.J.
dc.contributor.author McHutchison J.G.
dc.contributor.author Sievert W.
dc.contributor.author Sharara A.I.
dc.contributor.author Brown K.A.
dc.contributor.author Flisiak R.
dc.contributor.author Jacobson I.M.
dc.contributor.author Kershenobich D.
dc.contributor.author Manns M.P.
dc.contributor.author Schulman K.A.
dc.contributor.author Reed S.D.
dc.contributor.editor
dc.date Sep-2012
dc.date.accessioned 2017-10-05T15:38:09Z
dc.date.available 2017-10-05T15:38:09Z
dc.date.issued 2012
dc.identifier 10.1016/j.jval.2012.06.010
dc.identifier.isbn
dc.identifier.issn 10983015
dc.identifier.uri http://hdl.handle.net/10938/16160
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
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.relation.ispartofseries
dc.relation.uri
dc.source Scopus
dc.subject.other
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: ziad.gellad@duke.edu
dc.contributor.authorCorporate University: American University of Beirut Medical Center; Faculty: Faculty of Medicine; Department: Internal Medicine;
dc.contributor.authorDepartment Internal Medicine
dc.contributor.authorDivision
dc.contributor.authorEmail ziad.gellad@duke.edu
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.authorOrcidID
dc.contributor.authorReprintAddress Gellad, ZF (reprint author), Duke Univ, Sch Med, Duke Clin Res Inst, POB 17969, Durham, NC 27715 USA.
dc.contributor.authorResearcherID
dc.contributor.authorUniversity American University of Beirut Medical Center
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dc.description.citedCount 1
dc.description.citedTotWOSCount 1
dc.description.citedWOSCount 1
dc.format.extentCount 11
dc.identifier.articleNo
dc.identifier.coden VIHLF
dc.identifier.pubmedID 22999138
dc.identifier.scopusID 84866412445
dc.identifier.url
dc.publisher.address 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA
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dc.relation.ispartofConferenceCode
dc.relation.ispartofConferenceDate
dc.relation.ispartofConferenceHosting
dc.relation.ispartofConferenceLoc
dc.relation.ispartofConferenceSponsor
dc.relation.ispartofConferenceTitle
dc.relation.ispartofFundingAgency
dc.relation.ispartOfISOAbbr Value Health
dc.relation.ispartOfIssue 6
dc.relation.ispartOfPart
dc.relation.ispartofPubTitle Value in Health
dc.relation.ispartofPubTitleAbbr Value Health
dc.relation.ispartOfSpecialIssue
dc.relation.ispartOfSuppl
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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