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Hepatitis C disease transmission and treatment uptake: impact on the cost-effectiveness of new direct-acting antiviral therapies

Author

Listed:
  • Hayley Bennett

    (HEOR, Health Economics and Outcomes Research Ltd)

  • Jason Gordon

    (HEOR, Health Economics and Outcomes Research Ltd
    University of Adelaide)

  • Beverley Jones

    (HEOR, Health Economics and Outcomes Research Ltd)

  • Thomas Ward

    (HEOR, Health Economics and Outcomes Research Ltd)

  • Samantha Webster

    (HEOR, Health Economics and Outcomes Research Ltd)

  • Anupama Kalsekar

    (Bristol-Myers Squibb Pharmaceuticals Ltd)

  • Yong Yuan

    (Bristol-Myers Squibb Pharmaceuticals Ltd)

  • Michael Brenner

    (UK HEOR, Bristol-Myers Squibb Pharmaceuticals Ltd)

  • Phil McEwan

    (HEOR, Health Economics and Outcomes Research Ltd
    Swansea University)

Abstract

Background Hepatitis C virus (HCV) treatment can reduce the incidence of future infections through removing opportunities for onward transmission. This benefit is not captured in conventional cost-effectiveness evaluations of treatment and is particularly relevant in patient groups with a high risk of transmission, such as those people who inject drugs (PWID), where the treatment rates have been historically low. This study aimed to quantify how reduced HCV transmission changes the cost-effectiveness of new direct-acting antiviral (DAA) regimens as a function of treatment uptake rates. Methods An established model of HCV disease transmission and progression was used to quantify the impact of treatment uptake (10–100%), within the PWID population, on the cost-effectiveness of a DAA regimen versus pre-DAA standard of care, conducted using daclatasvir plus sofosbuvir in the UK setting as an illustrative example. Results The consequences of reduced disease transmission due to treatment were associated with additional net monetary benefit of £24,304–£90,559 per patient treated at £20,000/QALY, when 10–100% of eligible patients receive treatment with 100% efficacy. Dependent on patient genotype, the cost-effectiveness of HCV treatment using daclatasvir plus sofosbuvir improved by 36–79% versus conventional analysis, at 10–100% treatment uptake in the PWID population. Conclusions The estimated cost-effectiveness of HCV treatment was shown to improve as more patients are treated, suggesting that the value of DAA regimens to the NHS could be enhanced by improved treatment uptake rates among PWID. However, the challenge for the future will lie in achieving increased rates of treatment uptake, particularly in the PWID population.

Suggested Citation

  • Hayley Bennett & Jason Gordon & Beverley Jones & Thomas Ward & Samantha Webster & Anupama Kalsekar & Yong Yuan & Michael Brenner & Phil McEwan, 2017. "Hepatitis C disease transmission and treatment uptake: impact on the cost-effectiveness of new direct-acting antiviral therapies," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(8), pages 1001-1011, November.
    • Handle: RePEc:spr:eujhec:v:18:y:2017:i:8:d:10.1007_s10198-016-0844-8
    DOI: 10.1007/s10198-016-0844-8
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    References listed on IDEAS

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    1. Phil McEwan & Ray Kim & Yong Yuan, 2013. "Assessing the Cost Utility of Response-Guided Therapy in Patients with Chronic Hepatitis C Genotype 1 in the UK Using the MONARCH Model," Applied Health Economics and Health Policy, Springer, vol. 11(1), pages 53-63, February.
    2. Phil McEwan & Thomas Ward & Hayley Bennett & Anupama Kalsekar & Samantha Webster & Michael Brenner & Yong Yuan, 2015. "Estimating the Clinical and Economic Benefit Associated with Incremental Improvements in Sustained Virologic Response in Chronic Hepatitis C," PLOS ONE, Public Library of Science, vol. 10(1), pages 1-16, January.
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    More about this item

    Keywords

    Hepatitis C virus; Disease transmission; Cost-effectiveness; PWID;
    All these keywords.

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health

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