IDEAS home Printed from https://ideas.repec.org/
MyIDEAS: Login to save this article or follow this journal

Cost Effectiveness of Hepatitis C-Related Interventions Targeting Substance Users and Other High-Risk Groups: A Systematic Review

  • Ava John-Baptiste

    (Department of Medicine, University of Toronto, Toronto, ON, Canada; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University of Toronto, Toronto, ON, Canada; Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; University Health Network, Toronto, ON, Canada; Women's College Research Institute, Toronto, ON, Canada)

  • Man Wah Yeung

    (Department of Medicine, University of Toronto, Toronto, ON, Canada; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University of Toronto, Toronto, ON, Canada)

  • Victoria Leung

    (Department of Medicine, University of Toronto, Toronto, ON, Canada; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University of Toronto, Toronto, ON, Canada)

  • Gabrielle van der Velde

    (Toronto Health Economics and Technology Assessment (THETA) Collaborative, University of Toronto, Toronto, ON, Canada; Institute for Work and Health, Toronto, ON, Canada)

  • Murray Krahn

    (Department of Medicine, University of Toronto, Toronto, ON, Canada; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University of Toronto, Toronto, ON, Canada; Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; University Health Network, Toronto, ON, Canada; Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada)

Registered author(s):

    Background and Objective:Background and Objective: In developed countries, injection drug users have the highest prevalence and incidence of hepatitis C virus (HCV) infection. Clinicians and policy makers have several options for reducing morbidity and mortality related to HCV infection, including preventing new infections, screening high-risk populations, and optimizing uptake and delivery of antiviral therapy. Cost-effectiveness analyses provide an estimate of the value for money associated with adopting healthcare interventions. Our objective was to determine the cost effectiveness of hepatitis C interventions (prevention, screening, treatment) targeting substance users and other groups with a high proportion of substance users. Abstract: Methods:Methods: We conducted a systematic search of MEDLINE, EMBASE, CINAHL, HealthSTAR and EconLit, and the grey literature. Studies were critically appraised using the Drummond and Jefferson, Neumann et al. and Philips et al. checklists. We developed and applied a quality appraisal instrument specific to cost-effectiveness analyses of HCV interventions. In addition, we summarized cost-effectiveness estimates using a single currency and year ($US, year 2009 values). Abstract: Results:Results: Twenty-one economic evaluations were included, which addressed prevention (three), screening (ten) and treatment (eight). The quality of the analyses varied greatly. A significant proportion did not incorporate important aspects of HCV natural history, disease costs and antiviral therapy. Incremental cost-effectiveness ratios (ICERs) ranged from dominant (less costly and more effective) to $US603 352 per QALY. However, many ICERs were less than $US100 000 per QALY. Screening and treatment interventions involving pegylated interferon and ribavirin were generally cost effective at the $US100 000 per QALY threshold, with the exception of some subgroups, such as immune compromised patients with genotype 1 infections. Abstract: Conclusions:Conclusions: No clear consensus emerged from the studies demonstrating that prevention, screening or treatment provides better value for money as each approach can be economically attractive in certain subgroups. More high-quality economic evaluations of preventing, identifying and treating HCV infection in substance users are needed.

    If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.

    File URL: http://PharmacoEconomics.adisonline.com/pt/re/pec/pdfhandler.00019053-201230110-00004.pdf
    Download Restriction: Pay per view

    File URL: http://PharmacoEconomics.adisonline.com/pt/re/pec/fulltext.00019053-201230110-00004.htm
    Download Restriction: Pay per view

    As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.

    Article provided by Springer Healthcare | Adis in its journal PharmacoEconomics.

    Volume (Year): 30 (2012)
    Issue (Month): 11 ()
    Pages: 1015-1034

    as
    in new window

    Handle: RePEc:wkh:phecon:v:30:y:2012:i:11:p:1015-1034
    Contact details of provider: Web page: http://pharmacoeconomics.adisonline.com/

    No references listed on IDEAS
    You can help add them by filling out this form.

    This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

    When requesting a correction, please mention this item's handle: RePEc:wkh:phecon:v:30:y:2012:i:11:p:1015-1034. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dave Dustin)

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If references are entirely missing, you can add them using this form.

    If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    This information is provided to you by IDEAS at the Research Division of the Federal Reserve Bank of St. Louis using RePEc data.