BACKGROUND: The progression of hepatitis C virus (HCV) disease usually occurs over a 10-year period. HCV-related complications as well as the highly debilitating effects on patients represent a significant item of expenditure for the National Health Service. Early detection of HCV infection is an excellent opportunity to improve patients' quality of life and to rationalize resource allocation. OBJECTIVE: The aim of this study was to provide a cost-effectiveness evaluation of an anti-HCV screening program in the Italian National Health Service perspective. METHODS: We built a Markov model made up of two arms. The ''Test Strategy'' arm involves a screening program based on the enzyme immunoassay for detection of antibodies as first-level test and the research of HCV RNA as second-level detection; patients with positive test results are treated with peg-interferon alfa in combination with ribavirine. Parameters were derived from the literature and validated through experts' opinion. Costs and benefits were discounted by 3.5%. Results were expressed as cost/quality-adjusted life-year (QALY) gained through the screening program compared with the treatment of symptomatic patients. Deterministic and probabilistic sensitivity analysis was performed. RESULTS: The incremental cost-effectiveness ratio of the ''Test Strategy'' is €5171/QALY, definitively below the cost/QALY of other approved treatments in Italy. Model results turned out as sensitive to the age of the target population, the prevalence of HCV infection, and the time horizon adopted. CONCLUSIONS: The anti-HCV screening program is a valid health-related investment improving patients' quality of life and survival with an acceptable expenditure increase for the National Health Service.
BACKGROUND: The progression of hepatitis C virus (HCV) disease usually occurs over a 10-year period. HCV-related complications as well as the highly debilitating effects on patients represent a significant item of expenditure for the National Health Service. Early detection of HCV infection is an excellent opportunity to improve patients' quality of life and to rationalize resource allocation. OBJECTIVE: The aim of this study was to provide a cost-effectiveness evaluation of an anti-HCV screening program in the Italian National Health Service perspective. METHODS: We built a Markov model made up of two arms. The ''Test Strategy'' arm involves a screening program based on the enzyme immunoassay for detection of antibodies as first-level test and the research of HCV RNA as second-level detection; patients with positive test results are treated with peg-interferon alfa in combination with ribavirine. Parameters were derived from the literature and validated through experts' opinion. Costs and benefits were discounted by 3.5%. Results were expressed as cost/quality-adjusted life-year (QALY) gained through the screening program compared with the treatment of symptomatic patients. Deterministic and probabilistic sensitivity analysis was performed. RESULTS: The incremental cost-effectiveness ratio of the ''Test Strategy'' is €5171/QALY, definitively below the cost/QALY of other approved treatments in Italy. Model results turned out as sensitive to the age of the target population, the prevalence of HCV infection, and the time horizon adopted. CONCLUSIONS: The anti-HCV screening program is a valid health-related investment improving patients' quality of life and survival with an acceptable expenditure increase for the National Health Service.
Authors: Andrew J Leidner; Harrell W Chesson; Philip R Spradling; Scott D Holmberg Journal: Appl Health Econ Health Policy Date: 2017-02 Impact factor: 2.561
Authors: Paul G Carty; Christopher G Fawsitt; Paddy Gillespie; Patricia Harrington; Michelle O'Neill; Susan M Smith; Conor Teljeur; Mairin Ryan Journal: Appl Health Econ Health Policy Date: 2021-12-06 Impact factor: 3.686
Authors: Loreta A Kondili; Federica Romano; Francesca Romana Rolli; Matteo Ruggeri; Stefano Rosato; Maurizia Rossana Brunetto; Anna Linda Zignego; Alessia Ciancio; Alfredo Di Leo; Giovanni Raimondo; Carlo Ferrari; Gloria Taliani; Guglielmo Borgia; Teresa Antonia Santantonio; Pierluigi Blanc; Giovanni Battista Gaeta; Antonio Gasbarrini; Luchino Chessa; Elke Maria Erne; Erica Villa; Donatella Ieluzzi; Francesco Paolo Russo; Pietro Andreone; Maria Vinci; Carmine Coppola; Liliana Chemello; Salvatore Madonia; Gabriella Verucchi; Marcello Persico; Massimo Zuin; Massimo Puoti; Alfredo Alberti; Gerardo Nardone; Marco Massari; Giuseppe Montalto; Giuseppe Foti; Maria Grazia Rumi; Maria Giovanna Quaranta; Americo Cicchetti; Antonio Craxì; Stefano Vella Journal: Hepatology Date: 2017-10-30 Impact factor: 17.425
Authors: Loreta A Kondili; Ivane Gamkrelidze; Sarah Blach; Andrea Marcellusi; Massimo Galli; Salvatore Petta; Massimo Puoti; Stefano Vella; Homie Razavi; Antonio Craxi; Francesco S Mennini Journal: Liver Int Date: 2020-04-02 Impact factor: 5.828
Authors: Roberta Pastorino; Michele Basile; Alessia Tognetto; Marco Di Marco; Adriano Grossi; Emanuela Lucci-Cordisco; Franco Scaldaferri; Andrea De Censi; Antonio Federici; Paolo Villari; Maurizio Genuardi; Walter Ricciardi; Stefania Boccia Journal: PLoS One Date: 2020-07-01 Impact factor: 3.240