A UCLA/VA study found that for Hepatitis C patients who develop treatment-induced anemia due to a key medication, it is more cost-effective to take an additional drug to help prevent anemia, rather than reducing or stopping treatment altogether, which had been the standard approach.

IMPACT:
The study may lead to a new treatment standard for the one-third of Hepatitis C patients who develop treatment-induced anemia as a result of taking a key medication called ribarvirin. Over 4 million Americans are infected with Hepatitis C.

AUTHORS:
Dr. Brennan M.R. Spiegel, director, UCLA/VA Center for Outcomes Research and Education (CORE) and assistant professor of medicine, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, is available for interviews.

JOURNAL:
The research will appear in the Oct. 1 edition of the peer reviewed Clinical Gastroenterology and Hepatology. A PDF of the full study is available.

FUNDING:
Spiegel is supported with funding by a VA HSR&D Research Career Development Award. The research was also funded by Amgen Inc. Global Health Outcomes. Dr. Spiegel has received research funding from Amgen and has served as a consultant.

BACKGROUND:
Ribarvin, a common medication used in treating Hepatitis C, can cause anemia, which traditionally leads to dosage reduction and diminished treatment compliance by patients. Practice guidelines suggest that patients with anemia receive a drug called erythropoietin, which helps prevent treatment-induced anemia by increasing the number of red blood cells in the body. Erythropoietin has been proven to help patients maintain a full dose therapy of ribarvin, thus improving rates of complete cure from Hepatitis C. However, the drug is expensive, so it is unclear whether its benefits outweigh its cost.

UCLA researchers conducted a cost-effectiveness analysis and found that despite the high cost, co-therapy with erythropoietin proved more cost-effective compared to using the standard treatment in patients who experience treatment-induced anemia. Spiegel notes that a general cost-effectiveness standard accepted by society and many insurers for treating a chronic condition like Hepatitis C is roughly $50,000 per quality-adjusted life-year (QALY) gained. The study found that erythropoietin would cost an additional $16,443 per QALY gained for these patients, which is well in the acceptable cost level.

Rachel Champeau
rchampeaumednet.ucla.edu
310-794-0777
University of California - Los Angeles
newsroom.ucla.edu