Economic evaluation of the hepatitis C elimination strategy in Greece in the era of affordable direct-acting antivirals.
World J Gastroenterol
; 25(11): 1327-1340, 2019 Mar 21.
Article
em En
| MEDLINE
| ID: mdl-30918426
BACKGROUND: Hepatitis C virus (HCV) is a leading cause of worldwide liver-related morbidity and mortality. The World Health Organization released an integrated strategy targeting HCV-elimination by 2030. This study aims to estimate the required interventions to achieve elimination using updated information for direct-acting antiviral (DAA) treatment coverage, to compute the total costs (including indirect/societal costs) of the strategy and to identify whether the elimination strategy is cost-effective/cost-saving in Greece. AIM: To estimate the required interventions and subsequent costs to achieve HCV elimination in Greece. METHODS: A previously validated mathematical model was adapted to the Greek HCV-infected population to compare the outcomes of DAA treatment without the additional implementation of awareness or screening campaigns versus an HCV elimination strategy, which includes a sufficient number of treated patients. We estimated the total costs (direct and indirect costs), the disability-adjusted life years and the incremental cost-effectiveness ratio using two different price scenarios. RESULTS: Without the implementation of awareness or screening campaigns, approximately 20000 patients would be diagnosed and treated with DAAs by 2030. This strategy would result in a 19.6% increase in HCV-related mortality in 2030 compared to 2015. To achieve the elimination goal, 90000 patients need to be treated by 2030. Under the elimination scenario, viremic cases would decrease by 78.8% in 2030 compared to 2015. The cumulative direct costs to eliminate the disease would range from 2.1-2.3 billion euros () by 2030, while the indirect costs would be 1.1 billion. The total elimination cost in Greece would range from 3.2-3.4 billion by 2030. The cost per averted disability-adjusted life year is estimated between 10100 and 13380, indicating that the elimination strategy is very cost-effective. Furthermore, HCV elimination strategy would save 560-895 million by 2035. CONCLUSION: Without large screening programs, elimination of HCV cannot be achieved. The HCV elimination strategy is feasible and cost-saving despite the uncertainty of the future cost of DAAs in Greece.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Antivirais
/
Custos de Cuidados de Saúde
/
Análise Custo-Benefício
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Hepatite C
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Erradicação de Doenças
Tipo de estudo:
Health_economic_evaluation
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Screening_studies
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Sysrev_observational_studies
Limite:
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
World J Gastroenterol
Assunto da revista:
GASTROENTEROLOGIA
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Grécia