Details:

Alternative Title:
Appl Health Econ Health Policy
Personal Author:
Leidner, Andrew J. ; Chesson, Harrell W. ; Spradling, Philip R. ; Holmberg, Scott D.
Leidner, Andrew J. ; Chesson, Harrell W. ; Spradling, Philip R. ; Holmberg, Scott D. Less -
Description:
Background

Most cost-effectiveness analyses of hepatitis C (HCV) therapy focus on the benefits of reducing liver-related morbidity and mortality.

Objectives

Our objective was to assess how cost-effectiveness estimates of HCV therapy can vary depending on assumptions regarding the potential impact of HCV therapy on non-hepatic mortality.

Methods

We adapted a state-transition model to include potential effects of HCV therapy on non-hepatic mortality. We assumed successful treatment could reduce non-hepatic mortality by as little as 0 % to as much as 100 %. Incremental cost-effectiveness ratios were computed comparing immediate treatment versus delayed treatment and comparing immediate treatment versus non-treatment.

Results

Comparing immediate treatment versus delayed treatment, when we included a 44 % reduction in nonhepatic mortality following successful HCV treatment, the incremental cost per quality-adjusted life year (QALY) gained by HCV treatment fell by 76 % (from US$314,100 to US$76,900) for patients with no fibrosis and by 43 % (from US$62,500 to US$35,800) for patients with moderate fibrosis. Comparing immediate treatment versus non-treatment, assuming a 44 % reduction in non-hepatic mortality following successful HCV treatment, the incremental cost per QALY gained by HCV treatment fell by 64 % (from US$186,700 to US$67,300) for patients with no fibrosis and by 27 % (from US$35,000 to US$25,500) for patients with moderate fibrosis.

Conclusion

Including reductions in non-hepatic mortality from HCV treatment can have substantial effects on the estimated cost-effectiveness of treatment.


Subjects:
[+]
Article Cost-Benefit Analysis Disease Progression Health Care Costs Hepatitis C Humans Markov Chains Models, Statistical Mortality Quality-Adjusted Life Years
Source:
Appl Health Econ Health Policy. 15(1):65-74.
Pubmed ID:
27480538
Pubmed Central ID:
PMC5802335
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHS/United States
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:ab3a4c51d27091b3cd906e82d77e9e665257286273a0f3ac84635e7e66a14d6a
Download URL:
https://stacks.cdc.gov/view/cdc/51515/cdc_51515_DS1.pdf
File Type:

Supporting Files

• 	NIHMS934642-supplement-Appendix.pdf	pdf
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  	nihms934642f1.gif	gif
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