Cheng-Pin Chen1, Chien-Yu Cheng2, Huachun Zou3, Chun-Han Cheng4, Shu-Hsing Cheng5, Cheng-Kuo Chen6, Ching-Hsiang Chen6, Ming-Jong Bair7. 1. Division of Infectious Diseases, Department of Internal Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan. Electronic address: jangbin2@mail.tygh.gov.tw. 2. Division of Infectious Diseases, Department of Internal Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan; School of Public Health, National Yang-Ming University, Taipei, Taiwan. Electronic address: s841060@yahoo.com. 3. School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China; School of Public Health, Sun Yat-sen University, Guangzhou, China; Kirby Institute, University of New South Wales, Sydney, Australia. 4. Division of Gastroenterology, Department of Internal Medicine, Taitung Mackay Memorial Hospital, Taiwan. 5. Division of Infectious Diseases, Department of Internal Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan; School of Public Health, Taipei Medical University, Taipei, Taiwan. 6. Division of Gastroenterology and Hepatology, Department of Internal Medicine, China Medical University Hospital, Taichung City, Taiwan. 7. Division of Gastroenterology, Department of Internal Medicine, Taitung Mackay Memorial Hospital, Taiwan; Mackay Medical College, New Taipei City, Taiwan. Electronic address: a5963@mmh.org.tw.
Abstract
BACKGROUND: In Taiwan, the majority of chronic hepatitis C carriers with HIV co-infection are intravenous drug users and inmates in correctional facilities. Peginterferon and ribavirin (PegIFN/RBV) have been the standard-of-care for chronic hepatitis C virus (HCV) infection more than decades. We evaluated the estimated cost-effectiveness of PegIFN/RBV from the National Health Insurance Research Database, covering the population of Taiwan from 1998 to 2013. MATERIALS AND METHODS: This is an observational study, and study during was 2010-2016 and a total of 239 patients were treated with PegIFN/RBV. Of them, 156 patients were treated in the correctional facilities of Taipei, Taoyuan, Taichung and Taitung prisons, and 83 patients were treated in communities. The cost-effectiveness was analyzed in regimens of PegIFN/RBV and direct-acting antiviral agents. RESULTS: By multivariate analysis, the patients completed PegIFN/RBV in prison (adjusted odds ratio [aOR]: 4.56, 95% confidence interval [CI]: 1.58-13.12, p = 0.005), HCV RNA level <800,000 IU/mL (aOR: 4.0, 95% CI: 1.27-12.66, p = 0.02) at baseline, and the presence of early virologic response (EVR) (aOR: 7.67, 95% CI: 1.89-31.06, p = 0.004) were independent predictors for sustained virologic response (SVR). For the subgroups of prisoners, HIV-infected prisoners and HIV-infected patients in communities, the SVR rate was 73.8%, 72.0% and 36.8%, and the average medical-care cost was US$7,701, $7,893, and $15,443 per SVR achieved, respectively. Also, the estimated medical-care cost for genotype 6 was US$9211. CONCLUSIONS: Chronic HCV/HIV co-infected patients with genotype 1 and 6 in the community setting could benefit from DAAs in Taiwan.
BACKGROUND: In Taiwan, the majority of chronic hepatitis C carriers with HIV co-infection are intravenous drug users and inmates in correctional facilities. Peginterferon and ribavirin (PegIFN/RBV) have been the standard-of-care for chronic hepatitis C virus (HCV) infection more than decades. We evaluated the estimated cost-effectiveness of PegIFN/RBV from the National Health Insurance Research Database, covering the population of Taiwan from 1998 to 2013. MATERIALS AND METHODS: This is an observational study, and study during was 2010-2016 and a total of 239 patients were treated with PegIFN/RBV. Of them, 156 patients were treated in the correctional facilities of Taipei, Taoyuan, Taichung and Taitung prisons, and 83 patients were treated in communities. The cost-effectiveness was analyzed in regimens of PegIFN/RBV and direct-acting antiviral agents. RESULTS: By multivariate analysis, the patients completed PegIFN/RBV in prison (adjusted odds ratio [aOR]: 4.56, 95% confidence interval [CI]: 1.58-13.12, p = 0.005), HCV RNA level <800,000 IU/mL (aOR: 4.0, 95% CI: 1.27-12.66, p = 0.02) at baseline, and the presence of early virologic response (EVR) (aOR: 7.67, 95% CI: 1.89-31.06, p = 0.004) were independent predictors for sustained virologic response (SVR). For the subgroups of prisoners, HIV-infected prisoners and HIV-infectedpatients in communities, the SVR rate was 73.8%, 72.0% and 36.8%, and the average medical-care cost was US$7,701, $7,893, and $15,443 per SVR achieved, respectively. Also, the estimated medical-care cost for genotype 6 was US$9211. CONCLUSIONS:Chronic HCV/HIV co-infectedpatients with genotype 1 and 6 in the community setting could benefit from DAAs in Taiwan.
Authors: Zoe Ward; Nyashadzaishe Mafirakureva; Jack Stone; Mary Keevans; Graham Betts-Symonds; Desmond Crowley; Tina McHugh; Gordana Avramovic; John S Lambert; Peter Vickerman Journal: Int J Drug Policy Date: 2021-08-17
Authors: Giuseppe Scelza; Alessandra Amato; Antonio Maria Pagano; Giuseppe De Matteis; Rosa Caruso; Antonio Scelza; Laura Sisalli; Sebastiana De Biasi; Francesca Marigliano; Mario Gagliardi; Stefano Martina; Alfredo Iandolo Journal: Ann Gastroenterol Date: 2021-11-10
Authors: Klára Werling; Béla Hunyady; Mihály Makara; Krisztina Nemesi; Gábor Horváth; Ferenc Schneider; Judit Enyedi; Zsófia Müller; Miklós Lesch; Zoltán Péterfi; Tamás Tóth; Judit Gács; Zsuzsanna Fehér; Eszter Ujhelyi; Emese Molnár; Anna Nemes Nagy Journal: Viruses Date: 2022-02-02 Impact factor: 5.048