What Matters Most for Treatment Decisions in Hepatitis C: Effectiveness, Costs, and Altruism

Mattingly, T. Joseph; Slejko, Julia F.; Perfetto, Elèanor M.; Kottilil, Shyamasundaran; Mullins, C. Daniel

doi:10.1007/s40271-019-00378-7

Cited by 16 publications

(12 citation statements)

References 34 publications

(43 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Though nothing restricts health economists from incorporating the voice of HCV patients throughout their work, the number of HCV-specific CEAs that reflect value from the patient's perspective has been limited [14]. Here, we report the results of an economic model for HCV treatments guided by a patient-centered advisory board and informed by a patient-only Delphi panel to capture model variables and outcomes important to patients [15].…”

Section: Cost Effectiveness In Hepatitis C and The Potential For Patimentioning

confidence: 99%

“…The Value in Hepatitis C Virus Treatment Patient-Centered Model was developed by following the 10-Step Framework for Continuous Patient Engagement [12]. An 11-member, patient-centered, stakeholder advisory board (SAB) including four HCV patients, three infectious disease specialists, one general practitioner, two pharmacists, and a national patient advocacy organization representative was formed [15]. Health economists typically solicit clinical experts.…”

Section: Patient-centered Model Overviewmentioning

confidence: 99%

“…Formal voting was not requested if there was general consensus on a topic. The SAB helped inform the methods of the Delphi process, previously published, and the following economic model [15].…”

Section: Patient-centered Model Overviewmentioning

confidence: 99%

See 2 more Smart Citations

Value in Hepatitis C Virus Treatment: A Patient-Centered Cost-Effectiveness Analysis

et al. 2019

Self Cite

View full text Add to dashboard Cite

Background Innovations in hepatitis C virus (HCV) therapy included in traditional comparative evaluations focus on sustained virologic response (SVR) without addressing challenges patients report beyond virologic cure. This study aims to evaluate the cost-effectiveness of HCV drug therapy with a patient-centered approach. Methods An individual-based Markov model was constructed using guidance from a stakeholder advisory board (SAB), a patient Delphi panel, and published literature to evaluate direct-acting antivirals (DAAs) compared to no treatment. The United States (US) health sector and societal perspectives were considered for 10-and 20-year time horizons. Inputs for treatment costs and effectiveness reflect a generic regimen. Indirect costs used for the societal model included estimates from self-reported productivity in a matched-control sample. Beyond the traditional quality-adjusted life-year (QALY) health outcome, this study included two novel measures developed from the Delphi panel and SAB: infected life-years and workdays missed. All costs were measured in 2018 US dollars.Results Health sector costs and QALYs were higher in the treatment group in both 10-and 20-year models. Total infected life-years and workdays missed were reduced in the treatment group for both models. When costs of absenteeism, presenteeism, and patient/ caregiver time were included, the DAA intervention was cost-saving at both 10 and 20 years. Health sector results were sensitive to drug costs and utility estimates for post-SVR health states. Societal results were sensitive to presenteeism estimates and drug costs. Conclusion Treatment was cost-effective from a health sector perspective and cost-saving when including non-health costs such as patient/caregiver time and productivity.

show abstract

Section: Cost Effectiveness In Hepatitis C and The Potential For Patimentioning

confidence: 99%

Section: Patient-centered Model Overviewmentioning

confidence: 99%

See 1 more Smart Citation

Value in Hepatitis C Virus Treatment: A Patient-Centered Cost-Effectiveness Analysis

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…We did not identify costs specific to laboratory costs that were not rolled into [53]. When engaging HCV patients directly through qualitative interviews, advisory boards, focus groups, or Delphi panels, many patients report concerns that are difficult to measure in an observational study, such as impact on relationships, fear of harming others, financial stress, insurance issues, or stigma [54][55][56][57]. It may be difficult for researchers to accurately capture and quantify the real-world costs of some of these components reported by patients and attribute causality to HCV infection, leaving many of these constructs out of CEA designs [58].…”

Section: Discussionmentioning

confidence: 99%

Real World Cost-of-Illness Evidence in Hepatitis C Virus: A systematic review

2020

Self Cite

View full text Add to dashboard Cite

Background The introduction of direct-acting antivirals (DAAs) represents a potential clinical cure for hepatitis C virus (HCV) infection. Identification of costs associated with different stages of untreated disease through cost-of-illness (COI) evaluation helps inform policy decisions and cost-effectiveness analyses (CEAs). This study's objective was to review published real-world costs for patients with HCV to estimate the COI across different stages of disease progression. Methods A literature search of EMBASE, Scopus, and PubMed from January 1, 2010 to August 31, 2019 was conducted to identify real-world evidence related to HCV. Data extraction included citation details, population, study type, costing method used, currency and inflation adjustments, and disease-specific costs. Standardized costing method categories (sum all medical, sum diagnosis specific, matching, regression, other incremental, and other total) were assigned. The risk of bias was assessed at the outcome level for influence on costs attributable to HCV. Results The search strategy identified 278 studies, with 31 included in the final review after inclusion and exclusion criteria were applied. Retrospective cohorts (77%) and cross-sectional analyses (16%) were most frequently encountered. Sum Diagnosis Specific was the most common costing method (39%), followed by Regression (32%). Of the 31 studies analyzed, 35% included costs that would be included in a societal model. Costs were identified for various stages and complications related to HCV disease progression. Several studies included were determined to have a high (48%) or moderate risk (42%) of bias related to COI estimates. Conclusion Cost estimates for formal, informal, and non-health care services were identified in this review, but several challenges still exist in fully quantifying HCV burden. Future modeling studies including cost inputs should critically evaluate the risk of bias based on costing methods and data sources.

show abstract

“…In a qualitative study, patients ranked the anxiety associated with spreading a chronic infection as more important than the actual physical symptoms. 17 Particularly for chronic diseases, for which vaccines and treatments are available, considering psychological effects would be important to properly capturing the fear of contagion. Moreover, we could not itemize all affected sectors in detail, and we excluded health effects.…”

Section: Limitationsmentioning

confidence: 99%

Measuring “Fearonomic Effects” in Valuing Therapies: An Application to COVID-19 in China

Kim

Cohen

et al. 2020

Value in Health

View full text Add to dashboard Cite

Objectives To develop a checklist that helps quantify the economic impact associated with fear of contagion and to illustrate how one might use the checklist by presenting a case study featuring China during the coronavirus disease 2019 (COVID-19) outbreak. Methods Based on “fearonomic effects,” a qualitative framework that conceptualizes the direct and indirect economic effects caused by the fear of contagion, we created a checklist to facilitate empirical estimation. As a case study, we first identified relevant sectors affected by China’s lockdown policies implemented just before the Lunar New Year (LNY) week. To quantify the immediate impact, we then estimated the projected spending levels in 2020 in the absence of COVID-19 and compared these projections with actual spending during the LNY week. Data sources used include Chinese and global websites. To characterize uncertainty, we reported upper and lower bound estimates and calculated midpoints for each range. Results The COVID-19 epidemic is estimated to cost China’s economy $283 billion ($196-369 billion), that is, ¥2.0 trillion renminbi (¥1.4-¥2.6 trillion), during the LNY week. Reduced restaurant and movie theater business ($106 [$103-$109] billion, 37.5% [36.4%-38.5%]) and reduced public transportation utilization ($96 [$13-$179] billion dollars, 33.9% [4.6%-63.3%]) explain most of this loss, followed by travel restrictions and the resulting loss of hotel business and tourism ($80.36 billion, 28.4%). Conclusion Our checklist can help quantify the immediate and near-term impact of COVID-19 on a country’s economy. It can also help researchers and policy makers consider the broader economic and social consequences when valuing future vaccines and treatments.

show abstract

What Matters Most for Treatment Decisions in Hepatitis C: Effectiveness, Costs, and Altruism

Cited by 16 publications

References 34 publications

Value in Hepatitis C Virus Treatment: A Patient-Centered Cost-Effectiveness Analysis

Value in Hepatitis C Virus Treatment: A Patient-Centered Cost-Effectiveness Analysis

Real World Cost-of-Illness Evidence in Hepatitis C Virus: A systematic review

Measuring “Fearonomic Effects” in Valuing Therapies: An Application to COVID-19 in China

Contact Info

Product

Resources

About