Details of cost-Effectiveness of Interferon-alfa Therapy in Patients with Mile Chronic Hepatitis C.Compared by difference of clinical process between Japanese and American Patients.

慢性丙型肝炎感染是日本慢性肝病最常见的原因，它导致肝硬化和肝细胞癌引起的死亡。对于组织学上轻度慢性丙型肝炎患者，单疗程的α干扰素治疗可以在合理的边际成本下延长预期寿命。我们采用决策分析利用马尔可夫模型来预测终身临床和经济结果。在日本，35岁的轻度慢性丙型肝炎患者47%的生命周期费用用于干扰素治疗，而在美国，这一比例为30%，但干扰素治疗具有成本效益。另一方面，日本21%的肝细胞癌费用和美国25%的肝移植费用对生命年的延长贡献不大。日本治疗慢性丙型肝炎的终生费用高于美国。频繁的门诊就诊是推高总生命周期成本的主要原因。

Chronic Hepatitis C infection is the most common cause of chronic liver disease in Japan, and it results in deaths caused by liver cirrhosis and hepatocellular carcinoma. A single course of interferon alpha for patients with histologically mild chronic hepatitis C shouId prolong life expectancy at a reasonable marginal cost per year of life gained. We employed decision analysis utilizing a Markov model to project the life time clinical and economic outcomes. Though 47 % of life time costs of a 35 year old with mild chronic hepatitis C was spent for Interferon therapy in Japan and 30 % of them in the U.S., it was cost-effective. On thee other hand, 21% of the costs for hepatocellular carcinoma in Japan and 25% of the costs for liver transplantation in the U.S.contributed a little to life year prolongation. Lifetime costs for the treatment of chronic hepatitis C in Japan were higher than those in the U.S.. Frequent outpatient visits was a major causes to push up the total life time costs.