Estimation of hepatitis C costs in turkey VIA expert opinion: Delphi panel

Örmeci, Necati; Akarca, Ulus Salih; Aladağ, Mehmet Arif; Balık, İsmail; Kadayıfçı, Abdurrahman; Kalayci, CB; Kaymakoğlu, Sabahattin; Köksal, İftihar; Özkan, Hasan; Tabak, Fehmı; Saka, Günay

doi:10.1016/j.jval.2014.03.222

Cited by 4 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The cost of treatment in Turkey is a major bottleneck to the large scale roll-out in the country, despite DAA therapy being shown to be costeffective in other countries, when delivered at scale and in combination with prevention and screening strategies [28][29][30]. In Turkey, the average annual cost (excluding hepatitis C drug costs) of a patient with chronic hepatitis C, compensated cirrhosis, decompensated cirrhosis, HCC and liver transplant is US$ 446.83, US$ 577.56, US$ 1984.39, US$ 2474.15, US$ 42,469.27, respectively [31]. To reach the WHO targets, early diagnosis and treatment are crucial and cost-saving, as inaction or severe disease costs significantly more.…”

Section: Discussionmentioning

confidence: 99%

A micro-elimination approach to addressing hepatitis C in Turkey

İdilman

Razavi

Robbins-Scott

et al. 2020

BMC Health Serv Res

View full text Add to dashboard Cite

Background: In 2016, WHO passed the Global Health Sector Strategy on Viral Hepatitis (GHSS), calling for its elimination by 2030. Two years later, Turkey approved a strategy to reach the WHO targets. This study reports new national prevalence data, breaks it down by subpopulation, and models scenarios to reach HCV elimination. Methods: Literature was reviewed for estimates of HCV disease burden in Turkey. They were discussed with stakeholders and used as inputs to develop a disease burden model. The infected population was estimated by sequelae for the years 2015-2030. Three scenarios were developed to evaluate the disease burden in Turkey: a Base 2017 scenario, representing the current standard of care in Turkey; an increased treatment scenario, representing the impact of improved access to DAAs; and a WHO targets scenario, which meet the WHO GHSS viral hepatitis targets of a 65% reduction in mortality and 90% diagnosis rate of the infected population by 2030. Results: At the beginning of 2017, 271,000 viremic infections were estimated. Of these, 58,400 were diagnosed and 10,200 treated. Modelling results showed that, with the current treatment paradigm in Turkey, by 2030 the total number of viremic HCV infections would decline by 35%, while liver-related deaths, hepatocellular carcinoma (HCC), and decompensated cirrhosis would decrease by 10-25%. In the increased treatment scenario, by 2030 viremic HCV infections would decrease by 50%; liver-related deaths, HCC and decompensated cirrhosis would decrease by 45-70%. In the WHO targets scenario, HCV infections would decrease by 80%; sequelae would decrease by 80-85%. Data on disease burden in micro-elimination target subpopulations are largely unavailable. Conclusions: To meet the WHO Global Health Sector Strategy targets for the elimination of HCV, Turkey needs to increase treatment. Better data are needed as well as countrywide access to DAAs.

show abstract

Section: Discussionmentioning

confidence: 99%

A micro-elimination approach to addressing hepatitis C in Turkey

İdilman

Razavi

Robbins-Scott

et al. 2020

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…60 These services included diagnostic tests, such as anti-HCV antibody, HCV-RNA, and HCV genotyping tests. Medication costs were estimated by panel participants, and costs of other health states (chronic hepatitis, cirrhosis, decompensated cirrhosis, hepatocellular carcinoma, and liver transplantation) were based on previous studies 61 , 62 and used with currency and inflation adjustments. Costs of diagnostic tests were calculated as 8.62 Turkish liras (TL) for an anti-HCV antibody test, 111.87 TL for an HCV-RNA test, and 109.59 TL for an HCV genotyping test.…”

Section: Methodsmentioning

confidence: 99%

Modeling the Health Economic Burden of Hepatitis C Virus Infection in Turkey: Cost-Effectiveness of Targeted Screening

Çekın¹,

Güner

İnkaya

et al. 2023

Turk J Gastroenterol

View full text Add to dashboard Cite

Background/Aims: In 2016, World Health Organization introduced global goals to eliminate hepatitis C virus by 2030. The aim of this study is to analyze the epidemiologic and economic burden of hepatitis C virus in Turkey and compare current practice (regular care) with a hypothetical active screening and treatment approach (active scenario). Materials and Methods: A Markov model was used to analyze and compare regular care with a scenario developed by experts including the screening and treatment of all acute and chronic hepatitis C virus infections between 2020 and 2050. General and targeted populations were focused. The model reflected the natural history of the disease, and the inputs were based on a literature review and expert opinions. Costs were provided by previous studies and national regulations. Results: The active scenario resulted in higher spending for all groups compared with regular care in the first year. Cumulative costs were equalized in the 8th, 12th, 13th, and 16th year and followed by cost-savings of 49.7 million, 1.1 billion, 288.6 million, and 883.4 million Turkish liras in 20 years for prisoners, refugees, people who inject drugs (PWID), and all population, respectively. In all groups, the mortality was found to be lower with the active scenario. In total, 62.8% and 50.6% of expected deaths with regular care in 5 and 20 years, respectively, were prevented with the active scenario. Conclusions: An active screening and treatment approach for hepatitis C virus infection could be cost-effective for PWID, prisoners, and refugees. Almost two-thirds of deaths in regular care could be prevented in 5 years’ time with this approach.

show abstract

“…We reviewed the literature, and contacted persons involved in the elimination project in the country of Georgia to interpret published data to obtain costs of HCV testing, DAA treatment and liver disease, and HCV- and liver-related utilities ( Table 2 ) ( Jülicher & Galli, 2018 ; Ormeci et al, 2014 ; Cloherty et al, 2016 ). We adopted life-time liver disease costs from Turkey for viremic individuals ( Ormeci et al, 2014 ). We assumed that the costs of liver disease in stages F0-F3 decreased by 50% after achieving SVR.…”

Section: Methodsmentioning

confidence: 99%

Hepatitis C core antigen test as an alternative for diagnosing HCV infection: mathematical model and cost-effectiveness analysis

Sadeghimehr

Bertisch

Negro

et al. 2021

PeerJ

View full text Add to dashboard Cite

Background The cost and complexity of the polymerase chain reaction (PCR) test are barriers to diagnosis and treatment of hepatitis C virus (HCV) infection. We investigated the cost-effectiveness of testing strategies using antigen instead of PCR testing. Methods We developed a mathematical model for HCV to estimate the number of diagnoses and cases of liver disease. We compared the following testing strategies: antibody test followed by PCR in case of positive antibody (baseline strategy); antibody test followed by HCV-antigen test (antibody-antigen); antigen test alone; PCR test alone. We conducted cost-effectiveness analyses considering either the costs of HCV testing of infected and uninfected individuals alone (A1), HCV testing and liver-related complications (A2), or all costs including HCV treatment (A3). The model was parameterized for the country of Georgia. We conducted several sensitivity analyses. Results The baseline scenario could detect 89% of infected individuals. Antibody-antigen detected 86% and antigen alone 88% of infected individuals. PCR testing alone detected 91% of the infected individuals: the remaining 9% either died or spontaneously recovered before testing. In analysis A1, the baseline strategy was not essentially more expensive than antibody-antigen. In analysis A2, strategies using PCR became cheaper than antigen-based strategies. In analysis A3, antibody-antigen was again the cheapest strategy, followed by the baseline strategy, and PCR testing alone. Conclusions Antigen testing, either following a positive antibody test or alone, performed almost as well as the current practice of HCV testing. The cost-effectiveness of these strategies depends on the inclusion of treatment costs.

show abstract

Estimation of hepatitis C costs in turkey VIA expert opinion: Delphi panel

Cited by 4 publications

References 0 publications

A micro-elimination approach to addressing hepatitis C in Turkey

A micro-elimination approach to addressing hepatitis C in Turkey

Modeling the Health Economic Burden of Hepatitis C Virus Infection in Turkey: Cost-Effectiveness of Targeted Screening

Hepatitis C core antigen test as an alternative for diagnosing HCV infection: mathematical model and cost-effectiveness analysis

Contact Info

Product

Resources

About