COST-BENEFIT-ANALYSIS OF INTERFERON THERAPY IN CHILDREN WITH CHRONIC ACTIVE HEPATITIS-B

Background: alpha-Interferon is widely accepted for treatment of adult s with chronic hepatitis B, but its use remains limited in children, p artly because of questions regarding its cost effectiveness. The aim o f this study was to evaluate the cost effectiveness of alpha-interfero n for children with chronic active hepatitis B. Methods: We estimated the cost per year of life saved by alpha-interferon therapy for three cohorts of patients with chronic active hepatitis B treated at 2, 12, or 25 years of age. We assumed that only patients with active viral re plication would be treated and that a-interferon would prevent cirrhos is and hepatocellular carcinoma in a portion of the population treated . We calculated costs per year of life saved. Medical costs and years of life saved were discounted at 5% per year. Results: With a 30% resp onse rate to alpha-interferon, there was a net savings in both money a nd lives in the children's group with a minimal cost per year of life saved for adolescents (S510) and adults ($934). Years of life saved pe r person were greater for children (1.0) than adults (0.5). With a 6% response rate, estimated costs per year of life saved for children ($5 ,700) were one-fourth of those of adults ($22,100). Conclusions: alpha -interferon therapy for patients with chronic active hepatitis B is co st effective. alpha-Interferon is more cost effective in toddlers than adults because of the smaller dose required and the greater increase in life expectancy of children.