Cost-effectiveness of treatment for chronic hepatitis C

Concerns about the variable natural history of untreated chronic hepatitis C and the costs and benefits of current therapy for this disease have been addressed by the techniques of cost-effectiveness analysis. The methodologies of decision analysis and Markov computer simulation, and available data on natural history, costs of care, and response to treatment, have been utilized to project the long-term costs and benefits of treatment. These models indicate that interferon monotherapy and combination therapy (interferon plus ribavirin) for previously untreated patients, for retreatment of patients who relapse after interferon treatment, and for retreatment of those who are non-responders to interferon monotherapy have calculated cost-effectiveness ratios that fall within the bounds of other widely accepted therapies or are cost-saving. Even empirical treatment, without liver biopsy, HCV RNA quantitation, or HCV genotyping, has an acceptable cost-effectiveness.