Cost-effectiveness of increased screening and treatment of chronic hepatitis C in Korea

Kim, Do Young; Wong, Gabriel; Lee, Janet; Kim, Myung Hwa; Smith, Nathaniel J.; Blissett, Rob; Kim, Hyung Joon

doi:10.1080/03007995.2020.1756232

Cited by 6 publications

(7 citation statements)

References 44 publications

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“…In Germany by contrast, after a cost analysis, the recommendation was to screen all of the PWID population while applying a less extensive screening in the MSM and general population[ 78 ]. Screening all South Korean patients twice followed by SOF/LDV treatment was cost-effective as compared to the current high-risk screening, while GLE/PIB was not cost-effective[ 79 ].…”

Section: Can We Eradicate Hcv By 2030 With Daas Treatment?mentioning

confidence: 99%

Hepatitis C virus: A critical approach to who really needs treatment

Voumvouraki¹

2022

WJH

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Introduction of effective drugs in the treatment of hepatitis C virus (HCV) infection has prompted the World Health Organization to declare a global eradication target by 2030. Propositions have been made to screen the general population and treat all HCV carriers irrespective of the disease status. A year ago the new severe acute respiratory syndrome coronavirus 2 virus appeared causing a worldwide pandemic of coronavirus disease 2019 disease. Huge financial resources were redirected, and the pandemic became the first priority in every country. In this review, we examined the feasibility of the World Health Organization elimination program and the actual natural course of HCV infection. We also identified and analyzed certain comorbidity factors that may aggravate the progress of HCV and some marginalized subpopulations with characteristics favoring HCV dissemination. Alcohol consumption, HIV coinfection and the presence of components of metabolic syndrome including obesity, hyperuricemia and overt diabetes were comorbidities mostly responsible for increased liver-related morbidity and mortality of HCV. We also examined the significance of special subpopulations like people who inject drugs and males having sex with males. Finally, we proposed a different micro-elimination screening and treatment program that can be implemented in all countries irrespective of income. We suggest that screening and treatment of HCV carriers should be limited only in these particular groups.

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Section: Can We Eradicate Hcv By 2030 With Daas Treatment?mentioning

confidence: 99%

Hepatitis C virus: A critical approach to who really needs treatment

Voumvouraki¹

2022

WJH

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“…Our overall findings agree with previous studies that suggested the cost-effectiveness of universal HCV screening compared to no screening or risk-based screening in several countries [ 29 , 37 - 39 ]. In the economic evaluation studies of HCV screening for the Korean population, the universal screening was highly cost-effective as the estimated ICER was approximately $3,500–$9,000/QALY [ 8 - 10 ]. Cost-effectiveness varies depending on the healthcare system, medical service fees, treatment cost, and prevalence rate in each country [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

“…In particular, the DAA cost per course in Korea was $7,300–$18,500 according to the genotype just a few years ago, but the current cost is about $9,250 owing to a voluntary price cut by pharmaceutical companies since the advent of the pan genotypic DAA [ 41 ]. As a result, studies conducted after the price cut of DAA suggested a much lower ICER [ 8 ]. In addition to the price reduction of DAA, increased acceptance of DAA treatment and increased medical costs of severe health states, such as HCC and DC, led to a lower ICER compared to that seen in our previous work, although the same model was used [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

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A cost-effectiveness study of universal screening for hepatitis C virus infection in South Korea: A societal perspective

Kim

Choi

et al. 2022

Clin Mol Hepatol

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Background/Aims: This study aimed to evaluate the cost-effectiveness of hepatitis C virus (HCV) screening compared to no screening in the Korean population from societal and healthcare system perspectives.Methods: A published decision-tree plus Markov model was used to compare the expected costs and quality-adjusted life years (QALY) between one-time universal HCV screening and no screening in the population aged 40–65 years using the National Health Examination (NHE) program. Input parameters were obtained from analyses of the National Health Insurance claims data, Korean HCV cohort data, or from the literature review. The population aged 40–65 years was simulated in a model spanning a lifetime from both the healthcare system and societal perspectives, which included the cost of productivity loss due to HCV-related deaths. The incremental cost-effectiveness ratio (ICER) between universal screening and no screening was estimated.Results: The HCV screening strategy had an ICER of $2,666/QALY and $431/QALY from the healthcare system and societal perspectives, respectively. Both ICERs were far less than the willingness-to-pay threshold of $25,000/QALY, showing that universal screening was highly cost-effective compared to no screening. In various sensitivity analyses, the most influential parameters on cost-effectiveness were the antibodies to HCV (anti-HCV) prevalence, screening costs, and treatment acceptance; however, all ICERs were consistently less than the threshold. If the anti-HCV prevalence was over 0.18%, screening could be cost-effective.Conclusions: One-time universal HCV screening in the Korean population aged 40–65 years using NHE program would be highly cost-effective from both healthcare system and societal perspectives.

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“…In a nationwide epidemiological study, 0.78% of participants tested positive for anti-HCV antibodies after adjustment for age, sex, and area of residence [ 6 ]. Additionally, 30.5–46.5% of the population with antiHCV antibodies had detectable HCV RNA [ 5 , 9 ]. Risk factors for HCV infections include older age, needle-stick injuries, dental procedures, multiple sexual partners, blood transfusions before 1991, and surgeries [ 10 ].…”

Section: Natural History Of Hepatitis C Virus (Hcv) Infectionmentioning

confidence: 99%

Cost-effectiveness of chronic hepatitis C screening and treatment

Lee¹,

Lee²,

Kim³

et al. 2022

Clin Mol Hepatol

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Hepatitis C virus (HCV) infection is the second most common cause of chronic liver disease in South Korea, with a prevalence ranging from 0.6% to 0.8%, and HCV infection incidence increases with age. The anti-HCV antibody test, which is cheaper than the HCV RNA assay, is widely used to screen for HCV infections; however, the underdiagnosis of HCV is a major barrier to the elimination of HCV infections. Although several risk factors have been associated with HCV infections, including intravenous drug use, blood transfusions, and hemodialysis, most patients with HCV infections present with no identifiable risk factors. Universal screening for HCV in adults has been suggested to improve the detection of HCV infections. We reviewed the cost-effectiveness of HCV screening and the methodologies used to perform screening. Recent studies have suggested that universal HCV screening and treatment using direct-acting antivirals represent cost-effective approaches to the prevention and treatment of HCV infection. However, the optimal timing and frequency of HCV screening remain unclear, and further studies are necessary to determine the best approaches for the elimination of HCV infections.

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Cost-effectiveness of increased screening and treatment of chronic hepatitis C in Korea

Cited by 6 publications

References 44 publications

Hepatitis C virus: A critical approach to who really needs treatment

Hepatitis C virus: A critical approach to who really needs treatment

A cost-effectiveness study of universal screening for hepatitis C virus infection in South Korea: A societal perspective

Cost-effectiveness of chronic hepatitis C screening and treatment

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