Roferon-A in Chronic Viral Hepatitis: Treatment, Clinical Outcomes, Cost Effectiveness

Chronic liver infection due to viral hepatitis B and C is a major public health problem. Worldwide, an estimated 750 million people are carriers of these two viruses. Alpha-interferons, such as RoferonI-A, are currently the therapy of choice in chronic viral hepatitis B and C. They are effective in preventing disease progression and life-threatening sequelae: liver cirrhosis, ascites, hepatic encephalopathy, and variceal hemorrhage and/or hepatocellular carcinoma. On the other hand, discussion has been raised on the potentially enormous cost impact of these genetically engineered drugs in the treatment of an already costly disease. This study identifies and evaluates the long-term clinical and economic effects of RoferonI-A treatment in chronic viral hepatitis B and C over a time period of 10 to 20 years. Clinical and epidemiological data, as well as the detailed health care resource use and cost assessment, reflect the clinical and economic reality in Germany in 1993. A Markov model is used to predict the long-term clinical benefits of RoferonI-A therapy in terms of reduced morbidity and mortality. Based on this, direct costs, savings, and cost-effectiveness are analysed, including: RoferonI-A therapy initiation and follow-up, physician services, laboratory services, medicotechnical services, drug therapy, hospitalization as well as surgical interventions (liver transplantations).