دورية أكاديمية
Modeling cost-effectiveness and health gains of a 'universal' versus 'prioritized' hepatitis C virus treatment policy in a real-life cohort.
| العنوان: | Modeling cost-effectiveness and health gains of a 'universal' versus 'prioritized' hepatitis C virus treatment policy in a real-life cohort. |
|---|---|
| المؤلفون: | Kondili LA1, Romano F2, Rolli FR2, Ruggeri M2, Rosato S1, Brunetto MR3, Zignego AL4, Ciancio A5, Di Leo A6, Raimondo G7, Ferrari C8, Taliani G9, Borgia G10, Santantonio TA11, Blanc P12, Gaeta GB13, Gasbarrini A2, Chessa L14, Erne EM15, Villa E16, Ieluzzi D17, Russo FP15, Andreone P18, Vinci M19, Coppola C20, Chemello L15, Madonia S21, Verucchi G18, Persico M22, Zuin M23, Puoti M19, Alberti A15, Nardone G13, Massari M24, Montalto G25, Foti G26, Rumi MG23, Quaranta MG1, Cicchetti A2, Craxì Antonio, Vella S1, PITER Collaborating Group. |
| المساهمون: | Kondili LA1, Romano F2, Rolli FR2, Ruggeri M2, Rosato S1, Brunetto MR3, Zignego AL4, Ciancio A5, Di Leo A6, Raimondo G7, Ferrari C8, Taliani G9, Borgia G10, Santantonio TA11, Blanc P12, Gaeta GB13, Gasbarrini A2, Chessa L14, Erne EM15, Villa E16, Ieluzzi D17, Russo FP15, Andreone P18, Vinci M19, Coppola C20, Chemello L15, Madonia S21, Verucchi G18, Persico M22, Zuin M23, Puoti M19, Alberti A15, Nardone G13, Massari M24, Montalto G25, Foti G26, Rumi MG23, Quaranta MG1, Cicchetti A2, Craxì Antonio, Vella S1, PITER Collaborating Group. |
| بيانات النشر: | John Wiley and Sons Inc. |
| سنة النشر: | 2017 |
| المجموعة: | IRIS Università degli Studi di Palermo |
| مصطلحات موضوعية: | HCV |
| الوصف: | We evaluated the cost-effectiveness of two alternative direct-acting antiviral (DAA) treatment policies in a real-life cohort of hepatitis C virus–infected patients: policy 1, “universal,” treat all patients, regardless of fibrosis stage; policy 2, treat only “prioritized” patients, delay treatment of the remaining patients until reaching stage F3. A liver disease progression Markov model, which used a lifetime horizon and health care system perspective, was applied to the PITER cohort (representative of Italian hepatitis C virus–infected patients in care). Specifically, 8,125 patients naive to DAA treatment, without clinical, sociodemographic, or insurance restrictions, were used to evaluate the policies’ cost-effectiveness. The patients’ age and fibrosis stage, assumed DAA treatment cost of e15,000/patient, and the Italian liver disease costs were used to evaluate qualityadjusted life-years (QALY) and incremental cost-effectiveness ratios (ICER) of policy 1 versus policy 2. To generalize the results, a European scenario analysis was performed, resampling the study population, using the mean European countryspecific health states costs and mean treatment cost of e30,000. For the Italian base-case analysis, the cost-effective ICER obtained using policy 1 was e8,775/QALY. ICERs remained cost-effective in 94%-97% of the 10,000 probabilistic simulations. For the European treatment scenario the ICER obtained using policy 1 was e19,541.75/QALY. ICER was sensitive to variations in DAA costs, in the utility value of patients in fibrosis stages F0-F3 post–sustained virological response, and in the transition probabilities from F0 to F3. The ICERs decrease with decreasing DAA prices, becoming cost-saving for the base price (e15,000) discounts of at least 75% applied in patients with F0-F2 fibrosis. Conclusion: Extending hepatitis C virus treatment to patients in any fibrosis stage improves health outcomes and is cost-effective; cost-effectiveness significantly increases when lowering treatment prices in early fibrosis ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/28741307; info:eu-repo/semantics/altIdentifier/wos/WOS:000415922700042; volume:66; issue:6; firstpage:1814; lastpage:1825; numberofpages:12; journal:HEPATOLOGY; http://hdl.handle.net/10447/345385Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85033227727; http://onlinelibrary.wiley.com/journal/10.1002Test/(ISSN)1527-3350 |
| DOI: | 10.1002/hep.29399 |
| DOI: | 10.1002/(ISSN)1527-3350 |
| الإتاحة: | https://doi.org/10.1002/hep.29399Test http://hdl.handle.net/10447/345385Test |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.22672E48 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1002/hep.29399 |
|---|