Is the universal population Hepatitis C virus screening a cost-effective strategy? A systematic review of the economic evidence / ¿Es coste-efectivo realizar el cribado poblacional para la hepatitis C? Revisión sistemática de la evidencia farmacoeconómica
Ledesma, Francisco; Buti, María; Domínguez-Hernández, Raquel; Casado, Miguel Ángel; Esteban, Rafael.
Rev. esp. quimioter
; 33(4): 240-248, ago. 2020. tab, graf
Artigo
em Inglês
| IBECS (Espanha) | ID: ibc-197887
BACKGROUND:
Efficient strategies are needed in order to achieve the objective of the WHO of eradicating Hepatitis C virus (HCV). Hepatitis C infection can be eliminated by a combination of direct acting antiviral (DAA). The problem is that many individuals remain undiagnosed. The objective is to conduct a systematic review of the evidence on economic evaluations that analyze the screening of HCV followed by treatment with DAAs.METHODS:
Eleven databases were performed in a 2015-2018-systematic review. Inclusion criteria were economic evaluations that included incremental cost-effectiveness ratio (ICER) in terms of cost per life year gained or quality-adjusted life year.RESULTS:
A total of 843 references were screened. Sixteen papers/posters meet the inclusion criteria. Ten of them included a general population screening. Other populations included were baby-boomer, people who inject drugs, prisoners or immigrants. Comparator was "standard of care", other high-risk populations or no-screening. Most of the studies are based on Markov model simulations and they mostly adopted a healthcare payer's perspective. ICER for general population screening plus treatment versus high-risk populations or versus routinely performed screening showed to be below the accepted willingness to pay thresholds in most studies and therefore screening plus DAAs strategy is highly cost-effective.CONCLUSION:
This systematic review shows that screening programmes followed by DAAs treatment is cost-effective not only for high risk population but for general population too. Because today HCV can be easily cured and its long-term consequences avoided, a universal HCV screening plus DAAs therapies should be the recommended strategy to achieve the WHO objectives for HCV eradication by 2030
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