No abstract

No abstract

No abstract

objeCtives: Liver transplantation is an effective treatment option for end-stage liver disease and acute liver failure, including patients with hepatitis C (HCV) and hepatitis B (HBV). Recent health technology assessments of treatments for HCV and HBV have relied on data from a large cohort study of transplanted patients to inform estimates of costs of liver tranplantations; however this was conducted in the 1990s. The overall aim of this study was to estimate the current cost of liver transplant for patients with HCV and HBV in the UK. Methods: Historical summary data from the original cohort study were updated to reflect current unit costs and key changes in clinical practice. Semi-structured interviews were conducted with experts and a computer-based user-interface was developed to elicit estimates of key resource use items. Uncertainty in the experts' estimates was captured by eliciting probability distributions for each item from each expert. Updated unit costs were obtained from national sources. Data were analysed by phase of the transplant procedure. Results: The expert elicitation exercise included two hepatologists, three transplant surgeons and one liver transplant coordinator. Few patients with HBV are now being transplanted due to improvements in anti-viral treatments. Mean total costs for patients with HCV were £18,055 pre-transplantation, £64,452 during the transplant phase and £36,009 in two years post-transplant. The average cost per transplanted patient with HCV from assessment to two years post-transplant is £111,810. ConClusions: There have been some significant changes in clinical practice since the original study such as change in standard immunosuppressant therapy, more patients with co-morbidities being placed on the transplant waiting list, increased use of sub-optimal organs and reluctance to re-transplant patients with graft failure and recurrence of HCV.

No abstract