Assessment of Viral Genotype Impact to the Cost-Effectiveness and Overall Costs of Care for Peg-Interferon-2α + Ribavirine Treated Chronic Hepatitis C Patients

Background: pegylated interferon alfa plus ribavirin protocol is currently considered the most efficient hepatitis c treatment. however, no evidence of costs comparison among common viral genotypes has been published. objectives: we aimed to assess core drivers of hepatitis c medical care costs and compare cost effectiveness of this treatment among patients infected by hepatitis c virus with genotypes 1 or 4 (group i), and 2 or 3 (group ii). patients and materials: prospective bottom-up cost-effectiveness analysis from societal perspective was conducted at infectious diseases clinic, university clinic kragujevac, serbia, from 2007 to 2010. there were 81 participants with hepatitis c infection, treated with peg alpha-2a interferon plus ribavirin for 48 or 24 weeks. economic data acquired were direct inpatient medical costs, outpatient drug acquisition costs, and indirect costs calculated through human capital approach. results: total costs were significantly higher (p = 0.035) in group i (mean ± sd: 12,751.54 ± 5,588.06) compared to group ii (mean ± sd: 10,580.57 ± 3,973.02). in addition, both direct (p = 0.039) and indirect (p < 0.001) costs separately were significantly higher in group i compared to group ii. separate comparison within direct costs revealed higher total cost of medical care (p = 0.024) in first compared to second genotype group, while the similar tendency was observed for total drug acquisition (p = 0.072). conclusion: hcv genotypes 1 and 4 cause more severe clinical course require more care and thus incur higher expenses compared to hcv 2 and 3 genotypes. policy makers should consider willingness to pay threshold differentially depending upon hcv viral genotype detected.