The European Journal of Health Economics

, Volume 6, Issue 2, pp 112–123

Using competence network collaboration and decision-analytic modeling to assess the cost-effectiveness of interferon α-2b plus ribavirin as initial treatment of chronic hepatitis C in Germany

  • Uwe Siebert
  • Gaby Sroczynski
  • Jürgen Wasem
  • Wolfgang Greiner
  • Ulrike Ravens-Sieberer
  • Pamela Aidelsburger
  • Bärbel M. Kurth
  • Monika Bullinger
  • J.-Matthias Graf von der Schulenburg
  • John B. Wong
  • Siegbert Rossol
Original Papers

DOI: 10.1007/s10198-005-0280-7

Cite this article as:
Siebert, U., Sroczynski, G., Wasem, J. et al. Eur J Health Econ (2005) 6: 112. doi:10.1007/s10198-005-0280-7

Abstract

The objective of this study was to translate and apply a decision-analytic model for chronic hepatitis C (CHC) to the German health care context using competence network collaboration. The German Hepatitis C Model (GEHMO) competence network used a systematic multistep approach to identify and transfer a high quality Markov model for CHC to the German health care context. GEHMO was used to project lifetime clinical and economic outcomes and to determine the cost-effectiveness of initial antiviral therapy with interferon α-2b plus ribavirin from a societal perspective. In 40-year-old patients combination therapy for 24 and 48 weeks increased life expectancy by 1.6 and 2.3 years, respectively, compared with interferon alone for 48 weeks. The discounted incremental cost-utility ratios (ICUR) for combination therapy were €5,500 per quality-adjusted life-year gained (QALY) for 24 weeks and €6,800/QALY for 48 weeks of treatment. ICUR was €9,800/QALY for moving from 24 to 48 weeks of treatment. Combination therapy remained cost-effective in sensitivity analyses. In conclusion, combination therapy with interferon α-2b and ribavirin is effective and cost-effective compared with other well-accepted medical treatments. Competence network collaboration and decision modeling provide a useful and efficient approach to combine evidence from international studies with country-specific parameters.

Keywords

Chronic hepatitis CInterferon α-2bRibavirinCost-effectiveness analysisCompetence network collaboration

Copyright information

© Springer Medizin Verlag 2005

Authors and Affiliations

  • Uwe Siebert
    • 1
    • 2
    • 10
  • Gaby Sroczynski
    • 1
    • 2
  • Jürgen Wasem
    • 3
  • Wolfgang Greiner
    • 4
  • Ulrike Ravens-Sieberer
    • 5
  • Pamela Aidelsburger
    • 3
  • Bärbel M. Kurth
    • 6
  • Monika Bullinger
    • 7
  • J.-Matthias Graf von der Schulenburg
    • 4
  • John B. Wong
    • 8
  • Siegbert Rossol
    • 9
  1. 1.Institute for Technology Assessment and Department of RadiologyMassachusetts General Hospital, Harvard Medical SchoolBostonUSA
  2. 2.Program on Health Technology Assessment and Decision Sciences, Institute of Medical Informatics, Biometry, and EpidemiologyUniversity of MunichGermany
  3. 3.Alfried Krupp von Bohlen und Halbach-Chair for Medical ManagementUniversity of Duisburg-EssenGermany
  4. 4.Centre for Health Economics and Health System ResearchUniversity of HanoverGermany
  5. 5.Health Outcomes Research GroupRobert Koch InstituteBerlinGermany
  6. 6.Department for Epidemiology and Health ReportingRobert Koch InstituteBerlinGermany
  7. 7.Department of Medical PsychologyUniversity Hospital Hamburg-Eppendorf, University of HamburgGermany
  8. 8.Division of Clinical Decision Making, Department of MedicineTufts–New England Medical Center, Tufts University School of MedicineBostonUSA
  9. 9.Department of Internal MedicineGeneral HospitalRüsselsheimGermany
  10. 10.MGH Institute for Technology AssessmentHarvard Medical SchoolBostonUSA