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Letter
Antiviral treatment initiation costs in chronic hepatitis C
  1. U Siebert,
  2. J Wasem,
  3. S Rossol,
  4. G Sroczynski,
  5. P Aidelsburger,
  6. U Ravens-Sieberer,
  7. B M Kurth,
  8. M P Manns,
  9. J G McHutchison,
  10. J B Wong
  1. Harvard School of Public Health, Boston, Massachusetts, USA
  1. Correspondence to:
    Dr U Siebert
    Harvard School of Public Health, 718 Huntington Ave, Boston, Massachusetts 02115, USA; usieberthsph.harvard.edu

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    We thank Dr Poynard for his comments highlighting the role of pretreatment evaluation costs prior to antiviral treatment of patients with chronic hepatitis C (Gut 2003;52:1532). The rate of fibrosis progression varies among individuals with chronic hepatitis C, so liver biopsy can identify those with advanced disease who are at greatest risk for progressing to decompensated cirrhosis when therapeutic options are limited.1 Other testing, such as genotyping and viral load, can help estimate the likelihood of antiviral response or determine the duration of therapy, and still others are obtained for baseline values to monitor for potential side effects from therapy.

    In our cost effectiveness analyses of antiviral treatment strategies for chronic hepatitis C,2 treatment initiation costs included those related to procedures performed before the beginning of antiviral therapy: pregnancy test, quantitative hepatitis C virus (HCV)-RNA testing, HCV genotyping, thyroid stimulating hormone, thyroxine, and liver …

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