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Original Article

A health economic model to assess the long term effects and cost-effectiveness of PEG IFN α-2a in hepatitis C virus infected patients

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Objectives : Chronic Hepatitis C (CHC) is associated with longterm complications. Treating CHC with Pegylated interferon α-2a (PEG IFN α-2a) improves response rates and may contribute to less morbidity and mortality compared to standard interferon therapy. The objectives of this study were to estimate the longterm clinical consequences of such treatment as well as the resulting cost-effectiveness. Research design and methods : A Markov model was developed in order to predict the clinical and economic outcomes over a 25 year period. Three analyses were conducted : 1. for all Hepatitis C Virus (HCV) genotypes where PEG IFN α-2a was compared to interferon α-2a (IFN α-2a) in monotherapy for 48 weeks ; 2. for the HCV genotypes 1-4-5-6 comparing PEG IFN α-2a with interferon α-2b (IFN α-2b) both combined with ribavirin 1000/1200mg for 48 weeks ; and 3. where PEG IFN α-2a with 800 mg ribavirin was compared to IFN α-2b with ribavirin 1000/1200 mg for 24 weeks in genotypes 2 and 3. Results : In analysis one the cost-effectiveness of PEG IFN α-2a is 4,569 /quality adjusted life year (QALY) gained. In the second analysis, the result was € 14,763 / QALY, while for the 24 weeks therapy (analysis 3) the result was 903 per QALY gained. In an extensive sensitivity analysis cost-effectiveness was confirmed within reasonable assumptions. Conclusions : These results suggest that PEG IFN α-2a is costeffective in the management of all CHC patients. Real life evidence about longer term benefits of PEG IFN α-2a will be of importance for future decision making. [Product Details...]

The management of rectal cancer in Belgium : a survey of our practice

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In 1995, a Peer Review Commission Radiotherapy was installed at the initiative of the Belgian Ministry of Health as part of a larger pilot project on quality assurance. This commission was composed of 14 members, 8 radiation oncologists (appointed by the Belgian Association of Radiation Oncology) and 6 physicists (appointed by the Belgian Association of Hospital Physicists). Peer review is only one of the activities within the Quality control of the medical performance aiming to improve quality in diagnostic and therapeutic procedures. Other activities in Quality assurance are development of standards and guidelines, continuous education and measurements of the treatment process. In 1998, the Peer review Commission Radiotherapy has proposed to make a survey of rectal cancer management including diagnostic procedures and therapeutic approaches. More than 1300 questionnaires were sent to the chairman of the 25 Belgian radiotherapy departments, asking them to have it filled in by the radiation oncologist in charge of rectal cancer treatment in their department and to all the known surgeons from a list provided by the Ministry of Health. The paper reports and discuss the results of this survey. [Product Details...]

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