Cost-effectiveness analysis of interferon-alpha therapy in the treatment of chronic hepatitis B in Taiwan

Abstract

Background and purpose: Although interferon-alpha has been approved for chronic hepatitis B treatment in Taiwan, the high price necessitates study of its cost-effectiveness to define its role from a burden of disease perspective.

Method: A stimulation model was constructed to project the long-term effects of interferon treatment or standard care for a hypothetical group of 35-year-old chronic hepatitis B patients in Taiwan. Data on interferon treatment efficacy, disease progression, vital statistics, medical expenditure for various liver disease states, and quality-of-life measures based on Taiwan data were collected and used in the model.

Results: The model indicated that a 35-year-old chronic hepatitis B patient treated with interferon in Taiwan would have a life expectancy of 29.08 years, versus 28.67 years for the same patient who did not receive interferon. Corresponding to this gain in life expectancy of 0.41 years (or 0.18 quality-adjusted life-years, QALYs), the incremental cost-effectiveness ratio (ICER) was 492.000 New Taiwan dollars (NT$; 14,200 US$ at 34.7 NT$/US$) per QALY with an annual 3% discount rate. Monte Carlo simulation taking into account the range of plausible values for all model parameters indicated that 95% of the ICERs were in the range of 65,000 NT$ (1.900 US$)/QALY to 683,000 NT$ (19,700 US$)/QALY, and 90% of the ICERs were below 413,000 NT$ (11,900 US$)/QALY.

Conclusion: Interferon has a favorable cost-effectiveness profile in the treatment of chronic hepatitis B in Taiwan. However, the study results cannot be interpreted in isolation and need to be compared with the cost-effectiveness profiles of treatment regimens for other major chronic diseases in Taiwan.