Assessing the Effect of Potential Reductions in Non-Hepatic Mortality on the Estimated Cost-Effectiveness of Hepatitis C Treatment in Early Stages of Liver Disease

Details

• Alternative Title:
  Appl Health Econ Health Policy
• Personal Author:
  Leidner, Andrew J. ; Chesson, Harrell W. ; Spradling, Philip R. ; Holmberg, Scott D.
• 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:
  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
• Volume:
  15
• Issue:
  1
• 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:
  [PDF - 181.30 KB ]