Abstract

Objectives

Recently research shows that extending the duration of treatment with Peginterferon plus Ribavirin for 72 weeks can increase the rate of sustained viral response in individuals infected with genotype 1 hepatitis C who have slow virologic response after 24 weeks. The aim of this study was to evaluate whether the inclusion and extension of treatment for slow responders provides a cost-effectiveness favorable compared to treatment for 48 weeks.

Methods

A model based on Markov chains estimated costs and clinical consequences of treatment for 48 weeks excluding slow responders (Strategy 1) and treatment for 48 weeks for responders more extension to 72 weeks for slow responders (Strategy 2). The time horizon was 30 years. The costs and consequences were discounted 5% annually and analyzed from the perspective of the Brazilian National Health System. The utilities, transition probabilities, and efficacy data were extracted from the scientific literature.

Results

The strategy 2 showed an increase of 0.2 years of quality-adjusted life (QALYs) and ICER of U$17.532 compared to a strategy 1. The sensitivity analysis showed that even with variations in costs and effectiveness, strategy 2 remains below of cost effectiveness threshold.

Conclusion

The strategy of inclusion of individuals and slow responders extending treatment to 72 weeks in treatment recommendations presents the incremental cost-effectiveness acceptable when compared to standard procedure.