BOSTON, Nov. 9, 2014
/PRNewswire/ -- The newest and most effective drugs for the treatment
of hepatitis C have a cure rate of up to 98 percent, but the cost of
these therapies has been controversial. Accurately assessing the cost of
treating all patients with HCV in the US has yet to be determined.
of the problem is getting an accurate count of the Americans with HCV
as those with HCV are often asymptomatic and many are undiagnosed. The
Centers for Disease Control and Prevention (CDC) has recommended a
one-time age-based screening of all baby boomers (those born between
1945 and 1965). Risk-based screening was the standard protocol before
the CDC's recent recommendation.
Researchers used a decision
analytic Markov modeling approach to estimate the cost-effectiveness of
screening and treating patients with HCV. They created a model based on
five strategies of treatment and simulated patients until death:
They assumed treatment for
fibrosis stages F2 to F4, a 98 percent cure rate, and the cost of the
drugs at current prices. They assumed 1.2-1.4 million new patients would
be diagnosed with HCV from age-based screening. Treatment effectiveness
was measured in quality-adjusted life years, which assumes that
patients with HCV would live their lives without HCV progressing to
cirrhosis, decompensated liver disease, or liver transplantation.
Different screening and treatment strategies were compared to each other
based on the standard threshold for cost-effectiveness (incremental
cost-effectiveness ratio or ICER) from a societal perspective.
- Risk-based screening and treating all patients with HCV
- Age-based screening and treating all patients with HCV
- Risk-based screening and treating patients based on liver disease stage
- Age-based screening and treating patients based on liver disease stage
- No screening and no treatment
authors concluded that birth cohort screening followed by treating all
HCV (+) patients was the most cost-effective strategy with ICERs well
below the accepted threshold of $50,000 per quality adjusted years of life gained. The lead investigator, Zobair Younossi
MD, MPH, FAASLD concluded that "screening and treating baby boomers
with highly effective and well tolerated all oral anti-HCV regimens are
highly cost-effective with great health and economic benefits at the
population level." Dr. Younossi is Chairman of Medicine, Inova Fairfax
Medical Campus and Vice President for Research, Inova Health system, Falls Church, Virginia.
The use of all oral regimens for treatment of chronic hepatitis C
(CHC) coupled with birth cohort screening is highly cost effective: The
health and economic impact on the US population.
SOURCE American Association for the Study of Liver Diseases (AASLD)
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Labels: AASLD 2014, cost effectiveness of new treatments