Cost-effectiveness analysis of treatment with peginterferon-alfa-2a versus peginterferon-alfa-2b for patients with chronic hepatitis C under the public payer perspective in Brazil
dc.contributor.author | Barros, Fábio Marinho do Rêgo | pt_BR |
dc.contributor.author | Cheinquer, Hugo | pt_BR |
dc.contributor.author | Tsuchiya, Carolina Terumi | pt_BR |
dc.contributor.author | Santos, Eduardo | pt_BR |
dc.date.accessioned | 2015-03-07T01:57:09Z | pt_BR |
dc.date.issued | 2013 | pt_BR |
dc.identifier.issn | 1478-7547 | pt_BR |
dc.identifier.uri | http://hdl.handle.net/10183/111825 | pt_BR |
dc.description.abstract | Background: Chronic hepatitis C affects approximately 170 million people worldwide, and thus being one of the main causes of chronic liver disease. About 20% of patients with chronic hepatitis C will develop cirrhosis over 20 years, and present an increased risk of developing hepatic complications. Sustained virological response (SVR) is associated with a better prognosis compared to untreated patients and treatment failures. The objective of this analysis was to compare treatment costs and outcomes of pegylated interferon-alfa-2a versus pegylated interferon-alfa-2b, both associated with ribavirin, in the therapeutic scheme of 24 weeks and 48 week for hepatitis C genotypes 2/3 and genotype 1, respectively, under the Brazilian Public Health System (SUS) scenario. Methods: To project disease progression, a Markov model was built based on clinical stages of chronic disease. A Delphi panel was conducted to evaluate medical resources related to each stage, followed by costing of related materials, services, procedures and pharmaceutical products. The evaluation was made from a public payer perspective. The source used for costing was government reimbursement procedures list (SAI/SIH–SUS). Drug acquisition costs were obtained from the Brazilian Official Gazette and “Banco de Preços em Saúde” (government official source). It was assumed a mean patient weight of 70 kg. Costs were reported in 2011 Brazilian Reais (US$1 ≈ $Brz1.80). A systematic review followed by a meta-analysis of the 7 identified randomized controlled trials (RCTs) which compared pegylated interferons, was conducted for obtaining relative efficacy of both drugs: for genotype 2/3, mean rate of SVR was 79.2% for peginterferon-alfa-2a and 73.8% for peginterferon-alfa-2b. For genotype 1, SVR mean rate was 42.09% versus 33.44% (peginterferon-alfa-2a and peginterferon-alfa-2b respectively). Time horizon considered was lifetime. Discount rate for costs and outcomes was 5%, according to Brazilian guidelines for Health Technology Assessment (HTA). Results: Analysis showed that peginterferon-alfa-2a is a dominant therapy compared to peginterferon-alfa-2b for genotype 1 ($Brz 4,345 savings and 0.10 LY/0.25 QALY gains) as well for genotype 2/3 ($Brz 8,001 savings and 0.16 LY/0.39 QALY gains). Projections indicated that for each 1000 patients treated with peginterferon-alfa-2a instead of peginterferon-alfa-2b, the amount of resources saved would be of $Brz 4.3 million for genotypes 2/3 and up to $Brz 8 million for genotype 1. Conclusion: These findings suggest that treatment with peginterferon-alfa-2a is more effective and less costly when compared to peginterferon-alfa-2b under SUS perspective in Brazil. | en |
dc.format.mimetype | application/pdf | pt_BR |
dc.language.iso | eng | pt_BR |
dc.relation.ispartof | Cost Effectiveness and Resource Allocation. London. Vol. 11 (Oct. 2013), 9p. | pt_BR |
dc.rights | Open Access | en |
dc.subject | Hepatite C crônica | pt_BR |
dc.subject | Chronic hepatitis C | en |
dc.subject | Peginterferon-alfa-2a | en |
dc.subject | Interferon alfa | pt_BR |
dc.subject | Peginterferon-alfa-2b | en |
dc.subject | Avaliação de custo-efetividade | pt_BR |
dc.subject | Cost-effectiveness | en |
dc.subject | Sistema Único de Saúde | pt_BR |
dc.subject | Brazil | en |
dc.subject | SUS | en |
dc.title | Cost-effectiveness analysis of treatment with peginterferon-alfa-2a versus peginterferon-alfa-2b for patients with chronic hepatitis C under the public payer perspective in Brazil | pt_BR |
dc.type | Artigo de periódico | pt_BR |
dc.identifier.nrb | 000953086 | pt_BR |
dc.type.origin | Estrangeiro | pt_BR |
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