Triple Therapy for Chronic HCV Infection Is Cost-Effective in Some Patients

The new triple therapy regimens with peginterferon alfa, ribavirin, and boceprevir or telaprevir lead to high rates of sustained virologic response (SVR) in patients with hepatitis C virus (HCV) infection (JW Gastroenterol Mar 30 2011 and JW Gastroenterol Sep 16 2011). But, given their adverse effects, drug interactions, potential viral mutations, and expense, it is unclear whether these regimens are more cost-effective than dual therapy.

Now, European investigators have created a Markov decision model — using data from untreated patients with genotype 1 HCV infection and stage 2 liver fibrosis — to evaluate the cost-effectiveness of the following five strategies over a 20-year horizon:

• Boceprevir response-guided therapy (RGT)

• Boceprevir IL28B…