EMBARGOED FOR RELEASE UNTIL 5 P.M., EST, FRIDAY, NOVEMBER 14, 1997
November 15, 1997, Tip Sheet
Annals of Internal Medicine is published by the American College of Physicians (ACP), more than 100,000 physicians trained in internal medicine. The following highlights are not intended to substitute for articles as sources of information. For a copy of an article, call 1-800-523-1546, ext. 2656 or 215-351-2656. The full text of selected articles can be accessed on the Internet at http://www.acponline.org.
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Three Articles Find Interferon Cost-Effective for Treating Chronic Hepatitis C
Three articles conclude that treating chronic hepatitis C (HVC) with interferon is cost effective in selected patients. Chronic HVC progresses slowly, and interferon, the most effective treatment, is expensive and is successful in only a minority of patients. However, the growing number of people infected with HVC and possible consequences of the disease, such as cirrhosis, end-stage liver disease and liver cancer, make the cost-effectiveness of interferon treatment an important public health issue.
A decision analysis assumed that after a single six-month course of recombinant interferon in patients with mild chronic HVC, liver tests returned to normal and viral status remained negative in 27 percent. (Article, p. 855.) Such treatment was projected to prolong life expectancy at a reasonable marginal cost per year of life gained, particularly in younger patients.
In a second, independent study, a computer model found that the cost effectiveness of both six and 12 month therapy compared favorably with other established medical interventions, except possibly in patients older than 60 years. (Article, p. 866.)
In a prospective cohort study of 80 patients with chronic HVC and positive responses to six months of interferon therapy, all remained clinically disease and virus free in follow-up periods of from 1 to 7.6 years. (Article, p. 875.)
An editorial says that these decision analysis studies "seem to be the most comprehensive and best-conducted economic evaluations of the cost-effectiveness of interferon therapy for chronic hepatitis C" and that the third study shows convincingly that favorable treatment outcomes found after six months of treatment may be sustained for years. (Editorial, p. 918.)
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What Price for a Zero-Risk U.S. Blood Supply? Opportunities and Controversies (P. 904.)
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The Annual Physical Exam Has Changed Drastically Over the Years, Influenced by Changes in Scientific Knowledge, Organized Medicine, Life Insurance and Health Insurance Companies, Industry, and Public Health Sentiment. (History of Medicine, p. 910.)
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