Antivirals in Compensated Cirrhosis Found Cost-Effective
May be most cost-effective choice for patients with advanced liver disease from hepatitis C virus
FRIDAY, June 4 (HealthDay News) -- The antiviral treatment of patients with compensated cirrhosis may be the most cost-effective treatment option for patients with advanced liver disease caused by hepatitis C virus (HCV) infection, according to research published in the June issue of Liver Transplantation.
Sammy Saab, M.D., of the University of California in Los Angeles, and colleagues divided a 4,000-patient cohort of 55-year-olds with compensated cirrhosis into four treatment strategies: a control group that received no antiviral treatment and three groups treated with pegylated interferon and ribavirin -- a group with compensated cirrhosis, a group treated with antivirals after development of decompensated liver disease, and a group treated only after development of histological evidence of advanced fibrosis caused by HCV recurrence after transplantation.
Compared with no antiviral treatment, treatment during compensated cirrhosis was found to increase quality-adjusted life years (QALYs) by 0.950 and save $55,314. The researchers found that the use of antiviral treatment during decompensated cirrhosis increased QALYs by 0.044 and save $5,511, and treatment during post-transplant advanced recurrence increased QALYs by 0.061 and saved $3,223. Furthermore, treating patients with compensated cirrhosis resulted in 119 fewer deaths, 54 fewer hepatocellular carcinomas, and 66 fewer transplants compared to no treatment.
"The treatment of patients with compensated cirrhosis was found to be the most cost-effective strategy and resulted in improved survival and decreased cost in comparison with all other strategies. This study provides pharmacoeconomic evidence in support of treating HCV in patients with compensated cirrhosis before progression to more advanced liver disease," the authors write.