scholarly journals Eradicating hepatitis C: Are novel screening strategies for people who inject drugs cost-effective?

2020 ◽  
Vol 82 ◽  
pp. 102811 ◽  
Author(s):  
Francesco Manca ◽  
Emma Robinson ◽  
John F Dillon ◽  
Kathleen Anne Boyd
Keyword(s):  
Hepatitis C ◽  
People Who Inject Drugs ◽  
Cost Effective ◽  
Screening Strategies

scholarly journals How cost-effective is hepatitis C virus treatment for people who inject drugs?

2013 ◽  
Vol 28 (4) ◽  
pp. 590-592 ◽  
Author(s):  
Natasha K Martin ◽  
Peter Vickerman ◽  
Alec Miners ◽  
Matthew Hickman
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
People Who Inject Drugs ◽  
Cost Effective

scholarly journals The Cost-Effectiveness of Hepatitis C Virus Screening Strategies among Recently Arrived Migrants in the Netherlands

2020 ◽  
Vol 17 (17) ◽  
pp. 6091
Author(s):  
Mohamed N.M.T. Al Khayat ◽  
Job F.H. Eijsink ◽  
Maarten J. Postma ◽  
Jan C. Wilschut ◽  
Marinus van Hulst
Keyword(s):  
Hepatitis C Virus ◽  
Cost Effectiveness ◽  
Hepatitis C ◽  
The Netherlands ◽  
Budget Impact ◽  
Cost Effective ◽  
Life Years ◽  
Screening Strategies ◽  
Hcv Screening ◽  
The Cost

Objective: We aimed to assess the cost-effectiveness of hepatitis C virus (HCV) screening strategies among recently arrived migrants in the Netherlands. Methods: A Markov model was used to estimate the health effects and costs of HCV screening from the healthcare perspective. A cohort of 50,000 recently arrived migrants was used. In this cohort, three HCV screening strategies were evaluated: (i) no screening, (ii) screening of migrants from HCV-endemic countries and (iii) screening of all migrants. Results: Strategy (ii) screening of migrants from HCV-endemic countries compared to strategy (i) no screening, yielded an incremental cost-effectiveness ratio (ICER) of €971 per quality-adjusted life-years (QALYs) gained. Strategy (iii) screening of all migrants compared with strategy (ii) screening of migrants from HCV-endemic countries yielded an ICER of €1005 per QALY gained. The budget impact of strategy (ii) screening of migrants from HCV-endemic countries and strategy (iii) screening of all migrants was €13,752,039 and €20,786,683, respectively. Conclusion: HCV screening is cost-effective. However, the budget impact may have a strong influence on decision making.

Hepatitis C-related knowledge, attitudes and perceived risk behaviours among people who inject drugs in Kenya: A qualitative study

2021 ◽  
pp. 1-13
Author(s):  
Matthew J. Akiyama ◽  
Abbe Muller ◽  
Owen Huang ◽  
John Lizcano ◽  
Mercy Nyakowa ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Qualitative Study ◽  
Perceived Risk ◽  
People Who Inject Drugs ◽  
Risk Behaviours

Hepatitis C virus DAA treatment adherence patterns and SVR among people who inject drugs treated in opioid agonist therapy programs

2021 ◽  
Author(s):  
Moonseong Heo ◽  
Irene Pericot-Valverde ◽  
Lior Rennert ◽  
Matthew J Akiyama ◽  
Brianna L Norton ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Treatment Adherence ◽  
People Who Inject Drugs ◽  
Alcohol Intoxication ◽  
Sustained Viral Response ◽  
Time Frame ◽  
Agonist Therapy ◽  
Opioid Agonist ◽  
Direct Acting Antiviral

Abstract Background Adequate medication adherence is critical for achieving sustained viral response (SVR) of hepatitis C virus (HCV) among people who inject drugs (PWID). However, it is less known which patterns of direct-acting antiviral (DAA) treatment adherence are associated with SVR in this population or what factors are associated with each pattern. Methods The randomized three-arm PREVAIL study utilized electronic blister packs to obtain daily time frame adherence data in opiate agonist therapy program settings. Exact logistic regressions were applied to test the associations between SVR and six types of treatment adherence patterns. Results Of the 113 participants treated with combination DAAs, 109 (96.5%) achieved SVR. SVR was significantly associated with all pattern parameters except for number of switches between adherent and missed days: total adherent daily doses (exact AOR=1.12; 95%CI=1.04-1.22), percent total doses (1.09; 1.03-1.16), days on treatment (1.16; 1.05-1.32), maximum consecutive adherent days (1.34; 1.06-2.04), maximum consecutive non-adherent days (.85; .74-.95=.003). SVR was significantly associated with total adherent doses in the first two months of treatment, it was not in the last month. Compared to White participants (30.7±11.8(se)), Black (18.4±7.8) and Hispanic participants (19.2±6.1) had significantly shorter maximum consecutive adherent days. While alcohol intoxication was significantly associated with frequent switches, drug use was not associated with any adherence pattern. Conclusion Consistent maintenance of adequate total dose adherence over the entire course of HCV treatment is important in achieving SVR among PWID. Additional integrative addiction and medical care may be warranted for treating PWID experiencing alcohol intoxication.

Cost-Effectiveness of Nasopharyngeal Carcinoma Screening with Epstein-Barr Virus Polymerase Chain Reaction or Serology in High-Incidence Populations Worldwide

2020 ◽  
Author(s):  
Jacob A Miller ◽  
Quynh-Thu Le ◽  
Benjamin A Pinsky ◽  
Hannah Wang
Keyword(s):  
Cost Effectiveness ◽  
Epstein Barr Virus ◽  
Cost Effective ◽  
Chain Reaction ◽  
Men And Women ◽  
Barr Virus ◽  
Screening Strategies ◽  
High Incidence ◽  
Polymerase Chain ◽  
Epstein Barr

Abstract Background The incidence of endemic Epstein-Barr Virus (EBV)-associated nasopharyngeal carcinoma (NPC) varies considerably worldwide. In high-incidence regions, screening trials have been conducted. We estimated the mortality reduction and cost-effectiveness of EBV-based NPC screening in populations worldwide. Methods We identified 380 populations in 132 countries with incident NPC and developed a decision-analytic model to compare ten unique onetime screening strategies to no screening for men and women at age 50 years. Screening performance and the stage distribution of undiagnosed NPC were derived from a systematic review of prospective screening trials. Results Screening was cost-effective in up to 14.5% of populations, depending on the screening strategy. These populations were limited to East Asia, Southeast Asia, North Africa, or were Asian, Pacific Islander, or Inuit populations in North America. A combination of serology and nasopharyngeal polymerase chain reaction (PCR) was most cost-effective, but other combinations of serologic and/or plasma PCR screening were also cost-effective. The estimated reduction in NPC mortality was similar across screening strategies. For a hypothetical cohort of patients in China, 10-year survival improved from 71.0% (95%CI = 68.8%–73.0%) without screening to a median of 86.3% (range = 83.5%–88.2%) with screening. This corresponded to a median 10-year reduction in NPC mortality of 52.9% (range= 43.1%–59.3%). Screening interval impacted absolute mortality reduction and cost-effectiveness. Conclusions We observed decreased NPC mortality with EBV-based screening. Screening was cost-effective in many high-incidence populations and could be extended to men and women as early as age 40 years in select regions. These findings may be useful when choosing among local public health initiatives.

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