Support program improved HCV treatment results, cost-effectiveness

Carrión JA. J Hepatol. 2013;59:926-933.

  • January 7, 2014

A multidisciplinary support program increased the likelihood that patients would reach end of treatment and achieve sustained virologic response when using pegylated interferon alfa-2a and ribavirin to treat chronic hepatitis C, study results determined.

Such a program “improves patient compliance and increases the efficiency of PegIFN alfa-2a and [ribavirin] compared to the conventional approach and is also a cost-effective strategy,” the researchers wrote. “Close cooperation among the different professionals involved in the care of patients with [chronic hepatitis C] can ensure optimal treatment performance, achieving SVR as the main goal.”

The controlled study evaluated 447 patients receiving antiviral treatments, including a control group of 147 patients, a multidisciplinary support program (MSP) group of 131 patients and an additional MSP group of 169 patients meant to validate MSP efficacy.

Patients in the MSP had access to two hepatologists and two nurses, each working 40 hours weekly; a pharmacist, psychologist and administrative assistant, each working 20 hours weekly; and a psychiatrist when necessary.

Almost nine of 10 patients in the MSP and MSP validation arms reached end-of-treatment response (89.3% and 88.2%, respectively), compared with 79.6% of controls (P<.05 in all cases).

Patients achieving SVR also were significantly higher in the MSP and MSP validation groups (77.1% and 74.6%, respectively) in comparison with the control group (61.9%; P<.05 in all cases).

Taking part in the MSP was the main predictive factor in achieving SVR among patients with HCV genotype 1. SVR differences were not significant among patients with genotypes 2 and 3.

The study also analyzed cost-effectiveness using quality-adjusted life year (QALY) as the key metric. Patients in the MSP group were found to have saved €2,476 and increased 0.622 QALYs per genotype 1 or 4 patient.

“Inclusion of patients in an MSP team is a cost-effective strategy compared to conventional programs,” the researchers concluded.

Disclosure: See the study for a full list of relevant financial disclosures.