Economic evaluation of the hepatitis C elimination strategy in Greece in the era of affordable direct-acting antivirals

作     者：Ilias Gountas Vana Sypsa George Papatheodoridis Kyriakos Souliotis Kostas Athanasakis Homie Razavi Angelos Hatzakis 

作者机构：Department of HygieneEpidemiology and Medical StatisticsMedical SchoolNational and Kapodistrian University of Athens Hellenic Scientific Society for the Study of AIDS and Sexually Transmitted Diseases Department of GastroenterologyMedical SchoolNational and Kapodistrian University of AthensLaiko General Hospital Faculty of Social and Political SciencesUniversity of Peloponnese Department of Health EconomicsNational School of Public Health Center for Disease Analysis 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2019年第25卷第11期

页      面：1327-1340页

核心收录：

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 100401[医学-流行病与卫生统计学] 10[医学] 

基　　金：supported by unrestricted grants from Gilead and MSD 

主　　题：Hepatitis C elimination Cost effectiveness Cost of elimination Indirect costs Projections Mathematical modelling Awareness and screening programs World Health Organization targets 

摘      要：BACKGROUND Hepatitis C virus(HCV) is a leading cause of worldwide liver-related morbidity and mortality. The World Health Organization released an integrated strategy targeting HCV-elimination by 2030. This study aims to estimate the required interventions to achieve elimination using updated information for direct-acting antiviral(DAA) treatment coverage, to compute the total costs(including indirect/societal costs) of the strategy and to identify whether the elimination strategy is cost-effective/cost-saving in *** To estimate the required interventions and subsequent costs to achieve HCV elimination in *** A previously validated mathematical model was adapted to the Greek HCVinfected population to compare the outcomes of DAA treatment without the additional implementation of awareness or screening campaigns versus an HCV elimination strategy, which includes a sufficient number of treated patients. We estimated the total costs(direct and indirect costs), the disability-adjusted life years and the incremental cost-effectiveness ratio using two different price *** Without the implementation of awareness or screening campaigns,approximately 20000 patients would be diagnosed and treated with DAAs by2030. This strategy would result in a 19.6% increase in HCV-related mortality in2030 compared to 2015. To achieve the elimination goal, 90000 patients need to be treated by 2030. Under the elimination scenario, viremic cases would decrease by78.8% in 2030 compared to 2015. The cumulative direct costs to eliminate the disease would range from 2.1-2.3 billion euros(€) by 2030, while the indirect costs would be €1.1 billion. The total elimination cost in Greece would range from €3.2-3.4 billion by 2030. The cost per averted disability-adjusted life year is estimated between €10100 and €13380, indicating that the elimination strategy is very costeffective. Furthermore, HCV elimination strategy would save €560-895 million *** Without