Siebert, U.; Sroczynski, G.; Wasem, Jürgen; Greiner, W.; vd Schulenburg, J.M.; Aidelsburger, P.; Kurth, M.; Ravens-Sieberer, U.; Rossol, S.; Kurth, B.M.; Wong, J.B.; German Hepatitis C Model Group; International Hepatitis Interventional Therapy Group::

Using Competence Network Collaboration and Decision-Analytic Modelling to Assess the Cost-Effectiveness of Interferon a-2b plus Ribavirin as Initial Treatment of Chronic Hepatitis C in Germany.

In: European Journal of Health Economics, (2009) ; Nr. 6, S. 112-123
ISSN: 1618-7598
Zeitschriftenaufsatz / Fach: Wirtschaftswissenschaften; Medizin
Abstract:
The objective of this study was to translate and apply a decision-analytic model for chronic hepatitis C (CHC) to the German health care context using competence network collaboration. The German Hepatitis C Model (GEHMO) competence network used a systematic multistep approach to identify and transfer a high quality Markov model for CHC to the German health care context. GEHMO was used to project lifetime clinical and economic outcomes and to determine the cost-effectiveness of initial antiviral therapy with interferon a-2b plus ribavirin from a societal perspective. In 40-year-old patients combination therapy for 24 and 48 weeks increased life expectancy by 1.6 and 2.3 years, respectively, compared with interferon alone for 48 weeks. The discounted incremental cost-utility ratios (ICUR) for combination therapy were euro 5,500 per quality-adjusted life-year gained (QALY) for 24 weeks and euro 6,800/QALY for 48 weeks of treatment. ICUR was euro 9,800/QALY for moving from 24 to 48 weeks of treatment. Combination therapy remained cost-effective in sensitivity analyses. In conclusion, combination therapy with interferon alpha-2b and ribavirin is effective and cost-effective compared with other well-accepted medical treatments. Competence network collaboration and decision modeling provide a useful and efficient approach to combine evidence from international studies with country-specific parameters.