Cost-utility analysis of different peg-interferon alpha-2b plus ribavirin treatment strategies as initial therapy for naïve Chinese patients with chronic hepatitis C.

BACKGROUND: Different peg-interferon alpha-2b plus ribavirin treatment strategies are more effective in treating hepatitis C. However, no cost-effectiveness data have been published using the clinical data from the peg-interferon alpha-2b and ribavirin in the treatment of patients with hepatitis C in Taiwan. AIM: To estimate the cost-effectiveness of different treatments with peg-interferon alpha-2b plus ribavirin for the initial treatment of patients with different genotype chronic hepatitis C. METHODS: Individual patient level data from a randomized clinical trial with peg-interferon plus ribavirin were applied to a Markov model to project lifelong clinical outcomes. Economic estimates and quality of life were based on published data and Taiwan patient data. We used a societal perspective and applied a 3% annual discount rate. RESULTS: Compared with different combination therapy strategies, peg-interferon alpha-2b plus weight-based dosing of ribavirin in all patients for 24 weeks is the most cost-effective treatment strategy. If the sustained virological response of peg-interferon plus ribavirin treatment for 48 weeks therapy in genotype 1 patients was higher than 67.8%, the best strategy of treating patients will be the peg-interferon plus weight-based dosing of ribavirin therapy for 48 weeks in genotype 1 patients and for 24 weeks in non-genotype 1 patients. CONCLUSIONS: Peg-interferon alpha-2b plus ribavirin combination for 24 weeks therapy in all genotype patients should reduce the incidence of liver complications, prolong life, improve quality of life and be cost-effective for the initial treatment of chronic hepatitis C.

Order and chaos in semiconductor microstructures.

The semiclassical theory of ballistic electron transport in semiconductor microstructures provides a description of the quantum conductance fluctuations in terms of the classical distributions for the lengths and directed areas of the scattering trajectories. Because the classical dynamics differs for integrable (circular) and chaotic (stadium) scattering domains, experimental measurements of the conductance of these microstructures provide a unique probe of the quantum properties of classically regular and chaotic systems. To advance these theoretical and experimental studies we compare geometrical formulas for the classical distributions of lengths and areas with numerical simulations for microstructures examined in recent experiments, we assess the effects of lead size and placement, and we provide a critical analysis of the role of scattering "noise" on the classical and semiclassical predictions. Finally, we present a detailed comparison of the semiclassical theory with recent experimental measurements of the conductance fluctuations in circular- and stadium-shaped microstructures.