Trends in viral hepatitis cost-effectiveness studies. 2012

Sammy Saab, and Young Choi, and Harman Rahal, and Kun Li, and Myron Tong
Department of Medicine, Geffen School of Medicine, University of California, Los Angeles, 200 Medical Plaza, Ste 214, Los Angeles, CA 90095-7302, USA. ssaab@mednet.ucla.edu

Cost-effectiveness analyses compare the value of different treatment strategies, given that one strategy is more effective but also more costly than the other. The results are often used as a pharmacoeconomic basis to support a particular treatment strategy. To determine whether studies that reported favorable cost-effectiveness results in the antiviral treatment of hepatitis B and hepatitis C were more likely to be published. A systematic literature search was performed to identify all original cost-effectiveness studies published from 1987 through 2011 regarding antiviral treatment of hepatitis B or hepatitis C. Data were abstracted independently by 2 reviewers. Corresponding authors were also contacted. Of the 77 original cost-effectiveness analyses, 55 (71.4%) utilized a cost-effectiveness ratio below $50,000 per quality-adjusted life-year (QALY) in reaching a main conclusion for the study. A total of 46 analyses (59.74%) utilized ratios below $20,000/QALY. Most analyses (71 [92.2%]) reported favorable cost-effectiveness results. Countries outside of the United States and Europe tended to report lower cost-effectiveness ratios. Academic-funded studies were less likely to report cost-effectiveness ratios below $20,000/QALY. Most of the corresponding authors stated that their cost-effectiveness studies were published. Most published cost-effectiveness analyses regarding antiviral treatment of hepatitis B or hepatitis C reported favorable results. These results may suggest that researchers only attempt cost-effectiveness studies when there is a high likelihood of positive results. Regardless of the explicit cause of the bias, more awareness and scrutiny are needed when utilizing cost-effectiveness studies in decision making.

UI MeSH Term Description Entries
D007372 Interferons Proteins secreted by vertebrate cells in response to a wide variety of inducers. They confer resistance against many different viruses, inhibit proliferation of normal and malignant cells, impede multiplication of intracellular parasites, enhance macrophage and granulocyte phagocytosis, augment natural killer cell activity, and show several other immunomodulatory functions. Interferon
D003362 Cost-Benefit Analysis A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. In contrast a cost effectiveness in general compares cost with qualitative outcomes. Cost and Benefit,Cost-Benefit Data,Benefits and Costs,Cost Benefit,Cost Benefit Analysis,Cost-Utility Analysis,Costs and Benefits,Economic Evaluation,Marginal Analysis,Analyses, Cost Benefit,Analysis, Cost Benefit,Analysis, Cost-Benefit,Analysis, Cost-Utility,Analysis, Marginal,Benefit and Cost,Cost Benefit Analyses,Cost Benefit Data,Cost Utility Analysis,Cost-Benefit Analyses,Cost-Utility Analyses,Data, Cost-Benefit,Economic Evaluations,Evaluation, Economic,Marginal Analyses
D004359 Drug Therapy, Combination Therapy with two or more separate preparations given for a combined effect. Combination Chemotherapy,Polychemotherapy,Chemotherapy, Combination,Combination Drug Therapy,Drug Polytherapy,Therapy, Combination Drug,Chemotherapies, Combination,Combination Chemotherapies,Combination Drug Therapies,Drug Polytherapies,Drug Therapies, Combination,Polychemotherapies,Polytherapies, Drug,Polytherapy, Drug,Therapies, Combination Drug
D006509 Hepatitis B INFLAMMATION of the LIVER in humans caused by a member of the ORTHOHEPADNAVIRUS genus, HEPATITIS B VIRUS. It is primarily transmitted by parenteral exposure, such as transfusion of contaminated blood or blood products, but can also be transmitted via sexual or intimate personal contact. Hepatitis B Virus Infection
D006526 Hepatitis C INFLAMMATION of the LIVER in humans caused by HEPATITIS C VIRUS, a single-stranded RNA virus. Its incubation period is 30-90 days. Hepatitis C is transmitted primarily by contaminated blood parenterally and is often associated with transfusion and intravenous drug abuse. However, in a significant number of cases, the source of hepatitis C infection is unknown. Hepatitis, Viral, Non-A, Non-B, Parenterally-Transmitted,Parenterally-Transmitted Non-A, Non-B Hepatitis,PT-NANBH,Parenterally Transmitted Non A, Non B Hepatitis
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000998 Antiviral Agents Agents used in the prophylaxis or therapy of VIRUS DISEASES. Some of the ways they may act include preventing viral replication by inhibiting viral DNA polymerase; binding to specific cell-surface receptors and inhibiting viral penetration or uncoating; inhibiting viral protein synthesis; or blocking late stages of virus assembly. Antiviral,Antiviral Agent,Antiviral Drug,Antivirals,Antiviral Drugs,Agent, Antiviral,Agents, Antiviral,Drug, Antiviral,Drugs, Antiviral
D012254 Ribavirin A nucleoside antimetabolite antiviral agent that blocks nucleic acid synthesis and is used against both RNA and DNA viruses. Ribovirin,Tribavirin,ICN-1229,Rebetol,Ribamide,Ribamidil,Ribamidyl,Ribasphere,Vilona,Viramide,Virazide,Virazole,ICN 1229,ICN1229
D019057 Quality-Adjusted Life Years A measurement index derived from a modification of standard life-table procedures and designed to take account of the quality as well as the duration of survival. This index can be used in assessing the outcome of health care procedures or services. (BIOETHICS Thesaurus, 1994) Adjusted Life Year,Healthy Years Equivalent,QALYs,QUALYs,Quality Adjusted Life Year,Quality-Adjusted Life Year,Adjusted Life Years,Healthy Years Equivalents,Quality Adjusted Life Years,Equivalents, Healthy Years,Life Year, Adjusted,Life Year, Quality-Adjusted,Life Years, Adjusted,Life Years, Quality-Adjusted,QUALY,Years, Adjusted Life

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