The impact of direct acting antivirals on hepatitis C virus disease burden and associated costs in four european countries

Mennini, Francesco Saverio; Marcellusi, Andrea; Scott, Sarah Robbins; Montilla, Simona; Craxı̀, Antonio; Buti, Marı́a; Gheorghe, Liana; Ryder, Stephen; Kondili, Loreta A.

doi:10.1111/liv.14808

Cited by 18 publications

(32 citation statements)

References 35 publications

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“…The screening efficiency must be matched by a rapid linkage-to-care and cure of patients with HCV infection. The Italian evidence regarding the cost-effectiveness profile of HCV screening and DAA treatment produced from the Italian NHS perspective supports an evidence-based health policy for HCV elimination in Italy [14][15][16] . The evidence on cost benefits of treating patients diagnosed by screening is important for the ongoing central and regional decision-making process.…”

Section: Screening To Complete the Cascade Of Care And Achieve Hcv Eliminationmentioning

confidence: 85%

Milestones to reach Hepatitis C Virus (HCV) elimination in Italy: From free-of-charge screening to regional roadmaps for an HCV-free nation

Kondili

Aghemo

Andreoni

et al. 2022

Digestive and Liver Disease

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Section: Screening To Complete the Cascade Of Care And Achieve Hcv Eliminationmentioning

confidence: 85%

Milestones to reach Hepatitis C Virus (HCV) elimination in Italy: From free-of-charge screening to regional roadmaps for an HCV-free nation

Kondili

Aghemo

Andreoni

et al. 2022

Digestive and Liver Disease

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“…The outcomes for this cohort have been re-estimated since this analysis is based on novel data on real-life costs of disease management. The impact of real-life costs on model outcomes for 2015–2019 were evaluated versus a recent modelling analysis that considers the same treatment period and costs from the literature [ 9 ].…”

Section: Methodsmentioning

confidence: 99%

“… 0.150 0.120 0.180 115.21 652.88 [ 13 ] TP (following years) to death (l.r.) 0.057 0.050 0.068 127.93 2116.44 [ 13 ] Mortality (2015–2019) 0.062 0.043 0.103 11.31 17.38 [ 9 ] Mortality (post-screening) 0.044 0.039 0.069 40.54 885.98 [ 9 ] DAA effectiveness 2015–2019 F0-F3 to SVR (G1) 0.969 0.793 1.000 161.06 5.23 [ 14 ] F4-DC to SVR (G1) 0.950 0.760 1.000 96.08 5.10 [ 14 ] F0-F3 to SVR (G2) 0.928 0.767 1.000 64.13 4.97 [ 14 …”

Section: Methodsmentioning

confidence: 99%

“…Data availability statement Cost data were collected in the real life PITER cohort. The distribution of liver fibrosis in patients that will be diagnosed by treatment was based also in a modelling study [9] in which real life data of the PITER cohort were used. PITER is a multicentric prospective study that was approved by the Ethical Committee of Istituto Superiore di Sanità (Italian National Institute of Public Health) and the local ethical committees of each of clinical centres involved in the study.…”

Section: Supplementary Informationmentioning

confidence: 99%

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Economic Consequences of Anti-HCV Treatment of Patients Diagnosed Through Screening in Italy: A Prospective Modelling Analysis

Marcellusi

Simonelli

Mennini

et al. 2021

Appl Health Econ Health Policy

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Aim To evaluate the cost-consequences of the investment for anti-hepatitis C virus (HCV) treatment by the Italian National Health System (NHS) for patients who will be newly diagnosed through active HCV screening, implemented in Italy from 2020. Methods A previously published Markov model was used to estimate the disease complications avoided and the associated savings over 20 years to treat a standardised population of 10,000 HCV-infected patients diagnosed as a result of screening. Disease progression probabilities and fibrosis stage distribution were based on previously reported data in the literature. Real-life treatment effectiveness and medical expenses for disease management were estimated starting from a representative cohort of HCV-treated patients in Italy (Italian Platform for the Study of Viral Hepatitis Therapies). The breakeven point in time (BPT) was defined as the years required for the initial investment in treatment to be recovered in terms of cumulative costs saved. Results Over a 20-year time horizon, the treatment of 10,000 standardized patients diagnosed through active HCV screening results in 7769 avoided events of progression, which are associated with €838.73 million net savings accrued by the Italian NHS. The initial investment in treatment is recouped in 4.3 years in the form of savings from disease complications avoided. Conclusion Investment in treatment of newly diagnosed patients will bring a significant reduction in disease complications, which is associated with great economic benefits. This type of action can reduce the infection rate as well as the clinical and economic disease burden of HCV in Italy.Andrea Marcellusi and Claudia Simonelli equally contributed and should be considered as joint first authors.

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“…The return on investment for HCV antiviral therapy was estimated to range from 4 to 10 years, with the most favourable profile for countries where the restrictions for DAA treatment have been lifted. 23…”

Section: Pri Oritie S In H C V Eliminati On Prog R Ams For the Ne X T Dec Adementioning

confidence: 99%

Absolute targets for HCV elimination and national health policy paradigms: Foreseeing future requirements

Kondili

Craxı̀

Aghemo

2021

Liver International

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The World Health Organization (WHO) targets for eliminating HCV by 2030 may be overambitious for many high‐income countries. Recent analyses (ie, data from 2017 to 2019) show that only 11 countries are on track for meeting WHO’s elimination targets. For a country to be truly on track, it is important that the majority of infected individuals be identified and treated. There is still a need for country and population‐specific evaluations within the different HCV screening and treatment strategies available, in order to assess their cost‐effectiveness and sustainability and support an evidence‐based policy for HCV elimination. Any health policy model is affected by the diversity and quality of the available data and by gaps in data. Given the differences among countries, comparing progress based on fixed global targets will not necessarily be suitable in the same measure for each country. In a recent document, the European Collaborators of Polaris Observatory provide insight into the limitations of the current WHO targets. The absolute targets identified by each country in accordance with the measures set by WHO would be essential in reaching the HCV elimination. All analytic models to assess the progress towards HCV elimination are based on projections to 2030 not including the impact of the COVID‐19 pandemic on hepatitis‐related services. With specific regard to the achievement of WHO hepatitis elimination goals, all measures that will be put in place during and after COVID‐19 pandemic could be transferred in increasing diagnosis and linkage to care of people with hepatitis.

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The impact of direct acting antivirals on hepatitis C virus disease burden and associated costs in four european countries

Cited by 18 publications

References 35 publications

Milestones to reach Hepatitis C Virus (HCV) elimination in Italy: From free-of-charge screening to regional roadmaps for an HCV-free nation

Milestones to reach Hepatitis C Virus (HCV) elimination in Italy: From free-of-charge screening to regional roadmaps for an HCV-free nation

Economic Consequences of Anti-HCV Treatment of Patients Diagnosed Through Screening in Italy: A Prospective Modelling Analysis

Absolute targets for HCV elimination and national health policy paradigms: Foreseeing future requirements

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