Using competence network collaboration and decision-analytic modeling to assess the cost-effectiveness of interferon α-2b plus ribavirin as initial treatment of chronic hepatitis C in Germany

被引：15
作者：
Siebert U. [1 ,2 ,10 ]
Sroczynski G. [1 ,2 ]
Wasem J. [3 ]
Greiner W. [4 ]
Ravens-Sieberer U. [5 ]
Aidelsburger P. [3 ]
Kurth B.M. [6 ]
Bullinger M. [7 ]
Graf Von Der Schulenburg J.-M. [4 ]
Wong J.B. [8 ]
Rossol S. [9 ]
机构：
[1] Institute for Technology Assessment, Department of Radiology, Massachusetts General Hospital, Boston, MA
[2] Program on Health Technology Assessment and Decision Sciences, Institute of Medical Informatics, Biometry, and Epidemiology, University of Munich
[3] Alfried Krupp Von Bohlen und Halbach-Chair for Medical Management, University of Duisburg-Essen
[4] Centre for Health Economics and Health System Research, University of Hanover
[5] Health Outcomes Research Group, Robert Koch Institute, Berlin
[6] Department for Epidemiology and Health Reporting, Robert Koch Institute, Berlin
[7] Department of Medical Psychology, University Hospital Hamburg-Eppendorf, University of Hamburg
[8] Department of Medicine, Tufts-New England Medical Center, Tufts University School of Medicine, Boston, MA
[9] Department of Internal Medicine, General Hospital, Rüsselsheim
[10] MGH Institute for Technology Assessment, Harvard Medical School, Boston, MA
来源：
The European Journal of Health Economics | 2005年 / 6卷 / 2期
关键词：
Chronic hepatitis C; Competence network collaboration; Cost-effectiveness analysis; Interferon; α-2b; Ribavirin;
D O I：
10.1007/s10198-005-0280-7
中图分类号：
学科分类号：
摘要：
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 α-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 €5,500 per quality-adjusted life-year gained (QALY) for 24 weeks and €6,800/QALY for 48 weeks of treatment. ICUR was €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 α-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. © Springer Medizin Verlag 2005.
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页码：112 / 123
页数：11
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