TY - JOUR

T1 - 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

AU - Siebert, Uwe

AU - Sroczynski, Gaby

AU - Wasem, Jürgen

AU - Greiner, Wolfgang

AU - Ravens-Sieberer, Ulrike

AU - Aidelsburger, Pamela

AU - Kurth, Bärbel M.

AU - Bullinger, Monika

AU - Graf Von Der Schulenburg, J. Matthias

AU - Wong, John B.

AU - Rossol, Siegbert

PY - 2005/6

Y1 - 2005/6

N2 - 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.

AB - 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.

KW - Chronic hepatitis C

KW - Competence network collaboration

KW - Cost-effectiveness analysis

KW - Interferon α-2b

KW - Ribavirin

UR - http://www.scopus.com/inward/record.url?scp=21344473696&partnerID=8YFLogxK

U2 - 10.1007/s10198-005-0280-7

DO - 10.1007/s10198-005-0280-7

M3 - Article

C2 - 15902546

AN - SCOPUS:21344473696

VL - 6

SP - 112

EP - 123

JO - European Journal of Health Economics

JF - European Journal of Health Economics

SN - 1618-7598

IS - 2

ER -