Cost‐effectiveness analysis of hepatitis C virus (HCV) point‐of‐care assay for HCV screening

Koo, Vanessa; Tian, Feng; Wong, William

doi:10.1111/liv.15123

Cited by 8 publications

(10 citation statements)

References 30 publications

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“…Moreover, a recent state‐transition model (STM) analysing the cost‐utility of, respectively, the HCV point‐of‐care screening and the standard‐of‐care screening for PWIDs in Canada confirmed its medico‐economic interest 39 …”

Section: Discussionmentioning

confidence: 95%

“…In literature, Canadian and US experiments showed that the implementation of point‐of‐care HCV screening was cost‐saving for PWIDs 36–38 …”

Section: Discussionmentioning

confidence: 99%

“…In literature, Canadian and US experiments showed that the implementation of point-of-care HCV screening was cost-saving for PWIDs. [36][37][38] Moreover, a recent state-transition model (STM) analysing the cost-utility of, respectively, the HCV point-of-care screening and the standard-of-care screening for PWIDs in Canada confirmed its medico-economic interest. 39 Finally, although we did not specifically make a comparative evaluation between the strategy on dedicated days and the standard daily care in our addictive care centers, the particularly high prevalence of HCV RNA-positive patients who could be treated in our experience argues in favour of the dedicated days.…”

Section: Profitability Of the Scanvir Conceptmentioning

confidence: 95%

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Towards hepatitis C elimination in France: Scanvir, an effective model to test and treat drug users on dedicated days

Debette-Gratien

François

Chevalier

et al. 2023

Journal of Viral Hepatitis

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According to the French recommendations, the elimination of the hepatitis C virus by 2025 could be a realistic public health goal. Screening policies are being intensified, and access to treatment is promoted for patients who escape the usual care pathway.The 'Scanvir' program is an original strategy based on dedicated screening days, as part of the 'test, treat and cure HCV' event in addiction care centers in a French region, during which innovative screening technologies (RDTs, FibroScan® and pointof-care HCV RNA testing) are brought on site and access to a multidisciplinary team is offered. A total of 392 patients attended the 67 regional Scanvir sessions: 31.6%were HCV Ab-positive and 66% of them were HCV RNA-positive. Treatment was initiated in 79.3% of the patients. RDTs were accepted by 62% of the PWIDs (including those who already knew their status) and FibroScan® by 99.5% of the patients. 80% of the viremic patients started their treatment on site and are now cured or still under treatment. Advanced fibrosis evaluated by FibroScan® (LSM > 8 KPa) was suspected in 13.4% and 14.1% of the global and the HCV population, respectively. Scanvir is an efficient strategy for HCV elimination based on dedicated days aimed at increasing cost-effectiveness and offering a multidisciplinary service while saving human care resources. It is an exportable strategy that also offers comprehensive screening of associated chronic liver diseases via the elastometry device and interviews.

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Section: Discussionmentioning

confidence: 95%

“…In literature, Canadian and US experiments showed that the implementation of point‐of‐care HCV screening was cost‐saving for PWIDs 36–38 …”

Section: Discussionmentioning

confidence: 99%

Section: Profitability Of the Scanvir Conceptmentioning

confidence: 95%

See 1 more Smart Citation

Towards hepatitis C elimination in France: Scanvir, an effective model to test and treat drug users on dedicated days

Debette-Gratien

François

Chevalier

et al. 2023

Journal of Viral Hepatitis

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“…Given these findings the use of reflex testing to reduce loss between antibody and RNA testing and implementation of HCV screening through emergency departments that may prove useful in reaching high-risk populations may be warranted. Indeed, screening programmes implemented through emergency departments have been shown to be costeffective options along with the use of point-of-care assays that can facilitate HCV RNA diagnosis (17)(18)(19).…”

Section: Discussionmentioning

confidence: 99%

Engagement with the HCV care cascade among high-risk groups: a population-based study

Everett¹,

Wong

Forouzannia

et al. 2022

Preprint

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Background: Hepatitis C virus (HCV) elimination requires a thorough understanding of the care cascade. A direct-acting-antiviral (DAA)-era description of the care cascade has not been undertaken in Ontario, Canada. Our primary objective was to describe the current population-level care cascade in the general Ontario population and among key risk-groups ─ baby-boomers, immigrants, and individuals experiencing residential instability. The secondary objective was to identify predictors of engagement. Methods: We conducted a population-based cohort study of Ontario residents undergoing HCV testing between January 1, 1999, and December 31, 2018, and mapped the care cascade [antibody diagnosed, RNA tested, RNA positive, genotyped, treated, achieved sustained virologic response (SVR), reinfected/relapsed] as of December 31, 2018. The cascade was stratified by risk groups. Cause-specific hazard modeling was used to identify demographic, and socioeconomic predictors of engagement with key steps of the cascade. Results: Among 108,428 Ontario residents living with an HCV antibody diagnosis, 88% received confirmatory RNA testing; of these, 62% tested positive and 94% of positive tests were genotyped. Of those with confirmed viremia, 53% initiated treatment, and 76% of treated individuals achieved SVR, while ~1% experienced reinfection or relapse. Males, older birth cohorts, long-term residents, those with a history of substance use disorder and social marginalization (e.g., material deprivation, residential instability), and those initially diagnosed in the pre-DAA era exhibited lower rates of engagement with almost every step of HCV care. Conclusions: Despite DAA-era improvements, treatment initiation remains a major gap. HCV screening and linkage-to-treatment, particularly for those with a history of substance use disorder and social marginalization, will be needed to equitably close gaps in HCV care in Ontario.

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“…Point-of-care (POC) HCV RNA testing with the Xpert HCV VL Fingerstick test has a good diagnostic accuracy compared to laboratory-based testing following a venepuncture sampling [ 12 , 13 ]. POC HCV RNA testing reduces the transport and laboratory costs [ 14 , 15 ] and it shortens the time to treatment initiation [ 16 , 17 , 18 ]. While molecular POC testing has been implemented in some resource-limited settings, few studies have evaluated its efficacy.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Simplified HCV Diagnostics in HIV/HCV Co-Infected Patients in Myanmar

Nyein

Tillakeratne

Phyu

et al. 2023

Viruses

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To evaluate a decentralised testing model and simplified treatment protocol of hepatitis C virus (HCV) infection to facilitate treatment scale-up in Myanmar, this prospective, observational study recruited HIV–HCV co-infected outpatients receiving sofosbuvir/daclatasvir in Yangon, Myanmar. The study examined the outcomes and factors associated with a sustained virological response (SVR). A decentralised “hub-and-spoke” testing model was evaluated where fingerstick capillary specimens were transported by taxi and processed centrally. The performance of the Xpert HCV VL Fingerstick Assay in detecting HCV RNA was compared to the local standard of care ( plasma HCV RNA collected by venepuncture). Between January 2019 and February 2020, 162 HCV RNA-positive individuals were identified; 154/162 (95%) initiated treatment, and 128/154 (84%) returned for their SVR12 visit. A SVR was achieved in 119/154 (77%) participants in the intent-to-treat population and 119/128 (93%) participants in the modified-intent-to-treat population. Individuals receiving an antiretroviral therapy were more likely to achieve a SVR (with an odds ratio (OR) of 7.16, 95% CI 1.03–49.50), while those with cirrhosis were less likely (OR: 0.26, 95% CI 0.07–0.88). The sensitivity of the Xpert HCV VL Fingerstick Assay was 99.4% (95% CI 96.7–100.0), and the specificity was 99.2% (95% CI 95.9–99.9). A simplified treatment protocol using a hub-and-spoke testing model of fingerstick capillary specimens can achieve an SVR rate in LMIC comparable to well-resourced high-income settings.

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Cost‐effectiveness analysis of hepatitis C virus (HCV) point‐of‐care assay for HCV screening

Cited by 8 publications

References 30 publications

Towards hepatitis C elimination in France: Scanvir, an effective model to test and treat drug users on dedicated days

Towards hepatitis C elimination in France: Scanvir, an effective model to test and treat drug users on dedicated days

Engagement with the HCV care cascade among high-risk groups: a population-based study

Evaluation of Simplified HCV Diagnostics in HIV/HCV Co-Infected Patients in Myanmar

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