tokens: OBJECTIVES : Recently published studies have demonstrated increased efficacy and cost - effectiveness of combination therapy with interferon and alpha - 2b / ribavirin compared with interferon-alpha monotherapy in the treatment of chronic hepatitis C ( CHC ). Combination therapy is associated with a clinically important adverse effect : ribavirin - induced hemolytic anemia ( RIHA ). The objective of this study was to evaluate the direct health - care costs and management of RIHA during treatment of CHC in a clinical trial setting .