447 patients receiving antiviral treatment were distributed into 3 groups: control group (2003-2004, n = 147), MSP group (2005-2006, n = 131), and MSP-validation group (2007-2009, n = 169). The MSP group included two hepatologists, two nurses, one pharmacist, one psychologist, one administrative assistant, and one psychiatrist. Cost-effectiveness analysis was performed using a Markov model.
Adherence and SVR rates were higher in the MSP (94.6 % and 77.1 % ) and MSP-validation (91.7 % and 74.6 % ) groups compared to controls (78.9 % and 61.9 % ) (p <0.05 in all cases). SVR was higher in genotypes 1 or 4 followed by the MSP group vs. controls (67.7 % vs. 48.9 % , p = 0.02) compared with genotypes 2 or 3 (87.7 % vs. 81.4 % , p = n.s.). The MSP was the main predictive factor of SVR in patients with genotype 1. The rate of adherence in patients with psychiatric disorders was higher in the MSP groups (n = 95, 90.5 % ) compared to controls (n = 28, 75.7 % ) (p = 0.02). The cost per patient was 13,319 in the MSP group and 16,184 in the control group. The MSP group achieved more quality-adjusted life years (QALYs) (16.317 QALYs) than controls (15.814 QALYs) and was dominant in all genotypes.
MSP improves patient compliance and increases the efficiency of antiviral treatment in CHC, being cost-effective.