scholarly journals Cost comparison of treating chronic hepatitis C genotype one with pegylated interferons in Ukraine

Open Medicine ◽  
2015 ◽  
Vol 10 (1) ◽  
Author(s):  
Olena Mandrik ◽  
Saskia Knies ◽  
Оlha Golubovska ◽  
Oleksandr Duda ◽  
Larisa Dudar ◽  
...  
Keyword(s):  
Health Care ◽  
Body Weight ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Sensitivity Analyses ◽  
Average Dose ◽  
Patients Perspective ◽  
Average Body ◽  
Average Body Weight

AbstractBased on the pivotal trial showing no clinicallyrelevant differences between pegylated interferon α-2b (Peg-α-2b) and α-2a (Peg-α-2a) combined with ribavirin for treatment of chronic hepatitis C virus (HCV) genotype 1 infection in Ukraine, a cost-minimization analysis was performed using a 1 year time horizon and both a health care and patients’ perspective. A decision tree reflects treatment pathways. Drug costs were based on drug labeling and adjusted to the average body mass in Ukraine. Subgroup analysis was applied to deal with heterogeneity of patient’s weight causing dose changes. A break-even price of Peg-α-2a and Peg-α-2b (based on the average dose) was calculated. Univariate sensitivity analyses and probabilistic sensitivity analysis were carried out to reflect decision uncertainty. For an average body weight, total medical costs per patient differ from US$9220 for Peg-α-2b to US$9513 for Peg-α-2a from a health care perspective, and from US$15,212 to US$15,696 from a patients’ perspective. Sensitivity analyses show these results are robust. With average body weight, the break-even price of Peg-α-2b may be 7.3% higher than Peg-α-2a to have similar total costs.

scholarly journals Cost-Effectiveness of Testing for NS5A Resistance to Optimize Treatment of Elbasvir/Grazoprevir for Chronic Hepatitis C in China

2021 ◽  
Vol 12 ◽  
Author(s):  
Jinyu Liu ◽  
Yu Zhang ◽  
Bin Wu ◽  
Sen Wang ◽  
David Bin-Chia Wu ◽  
...  
Keyword(s):  
Health Care ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Health Care Cost ◽  
Nonstructural Protein ◽  
Potential Method ◽  
Sensitivity Analyses ◽  
Baseline Testing ◽  
The Impact

Objectives: Baseline presence of nonstructural protein 5A (NS5A) resistance-associated variants can attenuate the efficacy of new direct-acting antivirals. A potential method to attain the higher efficacy would be to screen for NS5A polymorphisms prior to the initiation of therapy and to adjust the treatment length based on the test results. However, baseline testing adds additional costs and it is unclear whether this would represent a high value strategy for chronic hepatitis C in China.Methods: A hybrid model compared 1) standard 12-weeks treatment (no testing), 2) shortened 8-weeks treatment (no testing), and 3) baseline testing with 12-/8-weeks treatment for those with/without NS5A polymorphisms from a lifetime Chinese health care payer perspective. All model inputs were retrieved from clinical trials and publically available literature. And sensitivity analyses were also conducted to assess the impact of uncertainty.Results: Baseline testing was associated with overall increase in total health care cost of USD 13.50 and in QALYs of 0.002 compared with standard 12-weeks treatment (no testing), yielded in an ICER of USD 6750/QALY gained. Scenario analyses suggested that shortened 8-weeks treatment (no testing) was found to be lower costs and great QALYs compared with other two strategies when the sustained virologic response (SVR) rate increased to 95%. Sensitivity analyses indicated that the results were robust.Conclusions: Our results suggest prior assessment of NS5A sensitivity followed by optimizing treatment duration was an economic strategy. In addition, shortened 8-weeks treatment (no testing) was shown to be dominant with the SVR rate increased to 95%.

scholarly journals Poor Perception of Body Weight Category amongst the Overweight and Obese with Chronic Hepatitis C: A Target for Intervention

2011 ◽  
Vol 2011 ◽  
pp. 1-8
Author(s):  
Venessa Pattullo ◽  
Nour Alkazaz ◽  
Sanjeev Sockalingam ◽  
E. Jenny Heathcote
Keyword(s):  
Body Weight ◽  
Chronic Hepatitis ◽  
Body Size ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Rating Scale ◽  
Size Perception ◽  
Weight Category ◽  
Targeted Interventions ◽  
Body Size Perception

Obesity in chronic hepatitis C (CHC) is associated with adverse hepatic and metabolic outcomes. This prospective study evaluates the agreement between self-perceived body weight (BW) status and measured body mass index (BMI) category and factors associated with its underestimation in CHC. Body size perception was measured with the Contour Drawing Rating Scale. Two hundred and seventy-three patients with CHC (overweight 45%, obese 18%) participated in this study. Although both overweight and obese demonstrated good body size perception, agreement between perceived BW and measured BMI categories was poor (κ=0.315, 95% CI 0.231–0.399); 33% of overweight/obese respondents considered themselves normal or underweight. Male gender (OR 2.84) and overweight (OR 2.42) or obese BMI (OR 14.19) were associated with underestimation of BW category. Targeted interventions are needed to improve body weight perception, thereby enhancing the uptake of health advice on management of excess body weight in CHC.

scholarly journals Clinical Encounters and Treatment Initiation for Chronic Hepatitis C Patients: Applications of Adaptive Leadership Framework for Chronic Illness

SAGE Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 215824401882446 ◽  
Author(s):  
Donald E. Bailey ◽  
Andrew J. Muir ◽  
Judith A. Adams ◽  
N. Marcus Thygeson ◽  
Hants Williams ◽  
...  
Keyword(s):  
Health Care ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Illness ◽  
Chronic Hepatitis C ◽  
Health Care Providers ◽  
The United States ◽  
Clinical Encounter ◽  
Adaptive Leadership ◽  
Care Providers

Chronic hepatitis C (CHC) is the most common blood-borne infection in the United States. Patients with CHC undergoing treatment face many challenges including adherence to medications and management of symptoms; health care practitioners are well positioned to facilitate patients’ ability to address these challenges. We used the Adaptive Leadership for Chronic Illness Framework to investigate the difficulties inherent in affecting behavior change in patients undergoing treatment. We enrolled 11 patient participants and 10 provider participants. We used data from the first clinical encounter between patients and providers during which treatment was discussed. We found examples of adaptive leadership and categorized these behaviors into three themes: support for medication, coping with family/home life, and strategizing to manage employment. We also saw examples of what we termed missed opportunities for adaptive leadership. This study illustrates the contributions of adaptive leadership behaviors by health care providers and the potential risk to patients in their absence.

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