The Costs and Impacts of Testing for Hepatitis C Virus Antibody in Public STD Clinics

Honeycutt, Amanda; Harris, Jennie; Khavjou, Olga; Buffington, Joanna; Jones, T. Stephen; Rein, David B.

doi:10.1177/00333549071220s211

Cited by 28 publications

(34 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We did not find any economic analyses of HBsAg screening of STD-clinic attendees, but 2 of HCV screening of STD-clinic attendees [46,64]. Universal screening and treatment of UK STD-clinic attendees was assessed as not cost-effective (ICER €125,933/QALY) [46,64].…”

Section: Resultsmentioning

confidence: 99%

Infection with hepatitis B and C virus in Europe: a systematic review of prevalence and cost-effectiveness of screening

et al. 2013

View full text Add to dashboard Cite

BackgroundTreatment for chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection is improving but not benefiting individuals unaware to be infected. To inform screening policies we assessed (1) the hepatitis B surface antigen (HBsAg) and anti-hepatitis C virus antibody (anti-HCV-Ab) prevalence for 34 European countries; and (2) the cost-effectiveness of screening for chronic HBV and HCV infection.MethodsWe searched peer-reviewed literature for data on HBsAg and anti-HCV-Ab prevalence and cost-effectiveness of screening of the general population and five subgroups, and used data for people who inject drugs (PWID) and blood donors from two European organizations. Of 1759 and 468 papers found in the prevalence and cost-effectiveness searches respectively, we included 124 and 29 papers after assessing their quality. We used decision rules to calculate weighted prevalence estimates by country.ResultsThe HBsAg and anti-HCV-Ab prevalence in the general population ranged from 0.1%-5.6% and 0.4%-5.2% respectively, by country. For PWID, men who have sex with men and migrants, the prevalence of HBsAg and anti-HCV-Ab was higher than the prevalence in the general population in all but 3 countries. There is evidence that HCV screening of PWID and HBsAg screening of pregnant women and migrants is cost-effective.ConclusionThe prevalence of chronic HBV and HCV infection varies widely between European countries. Anti-HCV-Ab screening of PWID and HBsAg screening of pregnant women and migrants have European public health priority. Cost-effectiveness analyses may need to take effect of antiviral treatment on preventing HBV and HCV transmission into account.

show abstract

Section: Resultsmentioning

confidence: 99%

Infection with hepatitis B and C virus in Europe: a systematic review of prevalence and cost-effectiveness of screening

et al. 2013

View full text Add to dashboard Cite

show abstract

“…We estimated that 80% of the patients aware of their HCV status would initiate HCV treatment (11, 25–28). Treatment regimens were assigned based on patients’ prior treatment history, HCV genotype, contraindication to interferon, and the standard-of-care at the time of treatment.…”

Section: Methodsmentioning

confidence: 99%

The Changing Burden of Hepatitis C Virus Infection in the United States: Model-Based Predictions

Kabiri¹,

Jazwinski²,

Roberts³

et al. 2014

Ann Intern Med

131

150

View full text Add to dashboard Cite

Background Chronic hepatitis C virus (HCV) infection causes substantial health and economic burden in the United States (US). With the availability of direct-acting antiviral agents (DAAs), recently approved and other therapies under development and 1-time birth-cohort screening, the burden of HCV disease is expected to decrease. Objective To predict the impact of new therapies and screening on chronic HCV cases and associated disease outcomes. Design Individual-level state-transition model. Setting Existing and anticipated HCV therapies and screening in the US. Patients Total HCV-infected population in the US. Measurements Chronic HCV cases and advanced-stage HCV outcomes. Results The number of chronic HCV cases decreased from 3.2 million in 2001 to 2.3 million in 2013. One-time birth-cohort screening beginning in 2013 is expected to identify 487 000 HCV cases in the next 10 years. In contrast, 1-time universal screening could identify 933 700 HCV cases. With the availability of highly effective therapies, HCV could become a rare disease in the next 22 years. The adoption of recently approved HCV therapies and one-time birth-cohort screening can prevent approximately 124 200 cases of decompensated cirrhosis, 78 800 cases of hepatocellular carcinoma, 126 500 liver-related deaths and 9900 liver transplants by 2050. Increasing the treatment capacity would further reduce the burden of HCV-related disease. Limitations Empirical data on the effectiveness of the future HCV therapies, on the future annual incidence of HCV, and on HCV treatment capacity are lacking. Conclusions New HCV therapies along with widespread implementation of screening and treatment will play an important role in reducing the burden of HCV disease. More aggressive screening recommendations are needed to identify a large pool of infected patients. Funding source National Institutes of Health.

show abstract

“…We assumed that 91% of those offered testing would accept and 90% of those who tested positive would receive their result and be evaluated for treatment [37]. To estimate the proportion of patients who would receive treatment we conducted a meta-analysis of rates of treatment found across 12 published studies of community treatment of patients with HCV infection only [14–25].…”

Section: Methodsmentioning

confidence: 99%

The Cost-effectiveness, Health Benefits, and Financial Costs of New Antiviral Treatments for Hepatitis C Virus

et al. 2015

Self Cite

View full text Add to dashboard Cite

Background New hepatitis C virus (HCV) treatments deliver higher cure rates with fewer contraindications, increasing demand for treatment and healthcare costs. The cost-effectiveness of new treatments is unknown. Methods We conducted a microsimulation of guideline testing followed by alternative treatment regimens for HCV among the US population aged 20 and older to estimate cases identified, treated, sustained viral response, deaths, medical costs, quality-adjusted life-years (QALYs), and the incremental cost-effectiveness ratio (ICER) of different treatment options expressed as discounted lifetime costs and benefits from the healthcare perspective. Results Compared to treatment with pegylated interferon and ribavirin (PR), and a protease inhibitor for HCV genotype (G) 1 and PR alone for G2/3, treatment with PR and Sofosbuvir (PRS) for G1/4 and treatment with Sofosbuvir and ribavirin (SR) for G2/3 increased QALYs by 555 226, reduced deaths by 80 682, and increased costs by $26.2 billion at an ICER of $47 304 per QALY gained. As compared to PRS/SR, treating with an all oral regimen of Sofosbuvir and Simeprevir (SS) for G1/4 and SR for G2/3, increased QALYs by 1 110 451 and reduced deaths by an additional 164 540 at an incremental cost of $80.1 billion and an ICER of $72 169. In sensitivity analysis, where treatment with SS effectiveness was set to the list price of Viekira Pak and then Harvoni, treatment cost $24 921 and $25 405 per QALY gained as compared to PRS/SR. Conclusions New treatments are cost-effectiveness per person treated, but pent-up demand for treatment may create challenges for financing.

show abstract

The Costs and Impacts of Testing for Hepatitis C Virus Antibody in Public STD Clinics

Cited by 28 publications

References 13 publications

Infection with hepatitis B and C virus in Europe: a systematic review of prevalence and cost-effectiveness of screening

Infection with hepatitis B and C virus in Europe: a systematic review of prevalence and cost-effectiveness of screening

The Changing Burden of Hepatitis C Virus Infection in the United States: Model-Based Predictions

The Cost-effectiveness, Health Benefits, and Financial Costs of New Antiviral Treatments for Hepatitis C Virus

Contact Info

Product

Resources

About