Department of Pharmacotherapy, College of Pharmacy, University of Utah, 30 South 2000 East, Salt Lake City, UT 84112, USA.
Am J Health Syst Pharm. 2009 Dec 15;66(24):2171-8. doi: 10.2146/ajhp080711.
Treatment persistence and cost of therapy for patients with chronic hepatitis C (CHC) treated with peginterferon alfa-2a plus ribavirin and peginterferon alfa-2b plus ribavirin were evaluated.
This retrospective database analysis used eligibility, pharmacy, and medical claims data from a large U.S. health plan for patients with CHC treated with peginterferon alfa-2a plus ribavirin and peginterferon alfa-2b plus ribavirin from January 2002 through June 2006. For the purposes of this analysis, the study population included all hepatitis C virus (HCV) genotypes. Comparable groups for assessment of outcomes were constructed using propensity score matching to reduce the effect of known sources of bias. Outcome variables included treatment persistence and annualized overall and HCV-attributable health care costs.
A total of 1783 matched pairs were analyzed. Compared with patients receiving peginterferon alfa-2a plus ribavirin, patients receiving peginterferon alfa-2b plus ribavirin were 18% less likely to be persistent with therapy at week 48 (p = 0.013). During the first six months of follow-up, mean all-cause costs (p = 0.0368) and HCV-attributable costs (p < 0.0001) were significantly lower for peginterferon alfa-2a plus ribavirin than for peginterferon alfa-2b plus ribavirin. Mean annualized all-cause costs (p = 0.0060) and HCV-attributable costs (p = 0.0167) over the entire follow-up period were significantly lower for patients treated with peginterferon alfa-2a plus ribavirin versus peginterferon alfa-2b plus ribavirin.
Analysis of information from a health care claims database suggests that treating CHC with peginterferon alfa-2a plus ribavirin may improve treatment persistence and help reduce the health care costs imposed by CHC compared with treatment with peginterferon alfa-2b plus ribavirin.
评估聚乙二醇干扰素 alfa-2a 联合利巴韦林和聚乙二醇干扰素 alfa-2b 联合利巴韦林治疗慢性丙型肝炎（CHC）患者的治疗持久性和治疗成本。
本回顾性数据库分析使用了来自美国一家大型健康计划的合格性、药房和医疗索赔数据，这些数据来自 2002 年 1 月至 2006 年 6 月期间接受聚乙二醇干扰素 alfa-2a 联合利巴韦林和聚乙二醇干扰素 alfa-2b 联合利巴韦林治疗的 CHC 患者。为了进行本分析，研究人群包括所有丙型肝炎病毒（HCV）基因型。使用倾向评分匹配来构建可比性组，以减少已知偏倚源的影响，从而评估结果。结果变量包括治疗持久性和年度总医疗保健成本和 HCV 归因医疗保健成本。
共分析了 1783 对匹配的患者。与接受聚乙二醇干扰素 alfa-2a 联合利巴韦林治疗的患者相比，接受聚乙二醇干扰素 alfa-2b 联合利巴韦林治疗的患者在第 48 周时治疗持续时间减少了 18%（p = 0.013）。在随访的前 6 个月中，聚乙二醇干扰素 alfa-2a 联合利巴韦林的全因成本（p = 0.0368）和 HCV 归因成本（p < 0.0001）显著低于聚乙二醇干扰素 alfa-2b 联合利巴韦林。在整个随访期间，聚乙二醇干扰素 alfa-2a 联合利巴韦林的年化全因成本（p = 0.0060）和 HCV 归因成本（p = 0.0167）显著低于聚乙二醇干扰素 alfa-2b 联合利巴韦林。
对医疗保健索赔数据库中的信息进行分析表明，与聚乙二醇干扰素 alfa-2b 联合利巴韦林治疗相比，用聚乙二醇干扰素 alfa-2a 联合利巴韦林治疗 CHC 可能会提高治疗的持久性，并有助于降低 CHC 带来的医疗保健成本。
