Estimating the cost-effectiveness of one-time screening and treatment for hepatitis C in Korea

doyoung kim, KwangHyub Han, Byungyool Jun, Tae Hyun Kim, Sohee Park, Thomas Ward, Samantha Webster, Phil McEwan

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background and Aims: This study aims to investigate the cost-effectiveness of a one-time hepatitis C virus (HCV) screening and treatment program in South Korea where hepatitis B virus (HBV) prevails, in people aged 40-70, compared to current practice (no screening). Methods: A published Markov model was used in conjunction with a screening and treatment decision tree to model patient cohorts, aged 40-49, 50-59 and 60-69 years, distributed across chronic hepatitis C (CHC) and compensated cirrhosis (CC) health states (82.5% and 17.5%, respectively). Based on a published seroepidemiology study, HCV prevalence was estimated at 0.60%, 0.80% and 1.53%, respectively. An estimated 71.7% of the population was screened. Post-diagnosis, 39.4% of patients were treated with a newly available all-oral direct-acting antiviral (DAA) regimen over 5 years. Published rates of sustained virologic response, disease management costs, transition rates and utilities were utilised. Results: Screening resulted in the identification of 43,635 previously undiagnosed patients across all cohorts. One-time HCV screening and treatment was estimated to be cost-effective across all cohorts; predicted incremental cost-effectiveness ratios ranged from $5,714 to $8,889 per quality-adjusted life year gained. Incremental costs associated with screening, treatment and disease management ranged from $156.47 to $181.85 million USD; lifetime costs-offsets associated with the avoidance of end stage liver disease complications ranged from $51.47 to $57.48 million USD. Conclusions: One-time HCV screening and treatment in South Korean people aged 40-70 is likely to be highly cost-effective compared to the current practice of no screening.

Original languageEnglish
Article number0167770
JournalPloS one
Volume12
Issue number1
DOIs
Publication statusPublished - 2017 Jan 1

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hepatitis C
cost effectiveness
Korea
Hepatitis C
Cost effectiveness
Cost-Benefit Analysis
Korean Peninsula
Screening
Hepacivirus
screening
Viruses
Hepatitis C virus
Costs and Cost Analysis
Disease Management
Costs
Therapeutics
Decision Trees
Republic of Korea
End Stage Liver Disease
Cost of Illness

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

kim, doyoung ; Han, KwangHyub ; Jun, Byungyool ; Kim, Tae Hyun ; Park, Sohee ; Ward, Thomas ; Webster, Samantha ; McEwan, Phil. / Estimating the cost-effectiveness of one-time screening and treatment for hepatitis C in Korea. In: PloS one. 2017 ; Vol. 12, No. 1.
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abstract = "Background and Aims: This study aims to investigate the cost-effectiveness of a one-time hepatitis C virus (HCV) screening and treatment program in South Korea where hepatitis B virus (HBV) prevails, in people aged 40-70, compared to current practice (no screening). Methods: A published Markov model was used in conjunction with a screening and treatment decision tree to model patient cohorts, aged 40-49, 50-59 and 60-69 years, distributed across chronic hepatitis C (CHC) and compensated cirrhosis (CC) health states (82.5{\%} and 17.5{\%}, respectively). Based on a published seroepidemiology study, HCV prevalence was estimated at 0.60{\%}, 0.80{\%} and 1.53{\%}, respectively. An estimated 71.7{\%} of the population was screened. Post-diagnosis, 39.4{\%} of patients were treated with a newly available all-oral direct-acting antiviral (DAA) regimen over 5 years. Published rates of sustained virologic response, disease management costs, transition rates and utilities were utilised. Results: Screening resulted in the identification of 43,635 previously undiagnosed patients across all cohorts. One-time HCV screening and treatment was estimated to be cost-effective across all cohorts; predicted incremental cost-effectiveness ratios ranged from $5,714 to $8,889 per quality-adjusted life year gained. Incremental costs associated with screening, treatment and disease management ranged from $156.47 to $181.85 million USD; lifetime costs-offsets associated with the avoidance of end stage liver disease complications ranged from $51.47 to $57.48 million USD. Conclusions: One-time HCV screening and treatment in South Korean people aged 40-70 is likely to be highly cost-effective compared to the current practice of no screening.",
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Estimating the cost-effectiveness of one-time screening and treatment for hepatitis C in Korea. / kim, doyoung; Han, KwangHyub; Jun, Byungyool; Kim, Tae Hyun; Park, Sohee; Ward, Thomas; Webster, Samantha; McEwan, Phil.

In: PloS one, Vol. 12, No. 1, 0167770, 01.01.2017.

Research output: Contribution to journalArticle

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AB - Background and Aims: This study aims to investigate the cost-effectiveness of a one-time hepatitis C virus (HCV) screening and treatment program in South Korea where hepatitis B virus (HBV) prevails, in people aged 40-70, compared to current practice (no screening). Methods: A published Markov model was used in conjunction with a screening and treatment decision tree to model patient cohorts, aged 40-49, 50-59 and 60-69 years, distributed across chronic hepatitis C (CHC) and compensated cirrhosis (CC) health states (82.5% and 17.5%, respectively). Based on a published seroepidemiology study, HCV prevalence was estimated at 0.60%, 0.80% and 1.53%, respectively. An estimated 71.7% of the population was screened. Post-diagnosis, 39.4% of patients were treated with a newly available all-oral direct-acting antiviral (DAA) regimen over 5 years. Published rates of sustained virologic response, disease management costs, transition rates and utilities were utilised. Results: Screening resulted in the identification of 43,635 previously undiagnosed patients across all cohorts. One-time HCV screening and treatment was estimated to be cost-effective across all cohorts; predicted incremental cost-effectiveness ratios ranged from $5,714 to $8,889 per quality-adjusted life year gained. Incremental costs associated with screening, treatment and disease management ranged from $156.47 to $181.85 million USD; lifetime costs-offsets associated with the avoidance of end stage liver disease complications ranged from $51.47 to $57.48 million USD. Conclusions: One-time HCV screening and treatment in South Korean people aged 40-70 is likely to be highly cost-effective compared to the current practice of no screening.

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