Estimating the Cost-Effectiveness of One-Time Screening and Treatment for Hepatitis C in Korea

Kim, Do Young; Han, Kwang Hyub; Jun, Byungyool; Kim, Tae Hyun; Park, So Hee; Ward, Thomas; Webster, S.; McEwan, Phil

doi:10.1371/journal.pone.0167770

Cited by 29 publications

(44 citation statements)

References 38 publications

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“…One-off HCV screening and treatment of people aged 40-70 years is likely to be very cost-effective compared with the current practice of no screening. 409 Importantly, to reduce the incidence of HCV-related endstage liver-related complications and mortality, a national screening programme should include a national health policy aimed at managing HCV in the South Korean population.…”

Section: The Lancet Gastroenterology and Hepatology Commissionmentioning

confidence: 99%

Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission

Sarin

Kumar

Eslam

et al. 2020

The Lancet Gastroenterology & Hepatology

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411

303

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The Asia-Pacific region is home to more than half of the global population and accounted for 62·6% of global deaths due to liver diseases in 2015. 54·3% of global deaths due to cirrhosis, 72·7% of global deaths due to hepatocellular carcinoma, and more than two-thirds of the global burden of acute viral hepatitis occurred in this region in 2015. Chronic hepatitis B virus (HBV) infection caused more than half of the deaths due to cirrhosis in the region, followed by alcohol consumption (20·8%), non-alcoholic fatty liver disease (NAFLD; 12·1%), and chronic infection with hepatitis C virus (HCV; 15·7%). In 2015, HBV accounted for about half the cases of hepatocellular carcinoma in the region. Preventive strategies for viral hepatitis-related liver disease include increasing access to clean drinking water and sanitation. HBV vaccination programmes for neonates have been implemented by all countries, although birthdose coverage is extremely suboptimal in some. Availability of screening tests for blood and tissue, donor recall policies, and harm reduction strategies are in their initial stages in most countries. Many governments have put HBV and HCV drugs on their essential medicines lists and the availability of generic versions of these drugs has reduced costs. Efforts to eliminate viral hepatitis as a public health threat, together with the rapid increase in per-capita alcohol consumption in countries and the epidemic of obesity, are expected to change the spectrum of liver diseases in the Asia-Pacific region in the near future. The increasing burden of alcohol-related liver diseases can be contained through government policies to limit consumption and promote less harmful patterns of alcohol use, which are in place in some countries but need to be enforced more strictly. Steps are needed to control obesity and NAFLD, including policies to promote healthy lifestyles and regulate the food industry. Inadequate infrastructure and insufficient health-care personnel trained in liver diseases are issues that also need to be addressed in the Asia-Pacific region. The policy response of most governments to liver diseases has thus far been inadequate and poorly funded. There must be a renewed focus on prevention, early detection, timely referral, and research into the best means to introduce and improve health interventions to reduce the burden of liver diseases in the Asia-Pacific region. 168 www.thelancet.com/gastrohep Vol 5 February 2020The Lancet Gastroenterology & Hepatology Commission accounted for 108 276 (8·2%) of the total liver-related deaths in the region in 2015, compared with 929 (1·2%) of 72 437 in the USA and 4032 (0·3%) of 197 179 in Europe. Deaths in the Asia-Pacific region represented three-quarters of the global total number of deaths due to acute viral hepatitis. In 2015, the region accounted for three-quarters of the global total number of deaths related to acute HBV, almost two-thirds of those due to acute hepatitis A infection, and almost 80% of those due to acute hepatitis E infection. Of all deaths du...

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Section: The Lancet Gastroenterology and Hepatology Commissionmentioning

confidence: 99%

Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission

Sarin

Kumar

Eslam

et al. 2020

The Lancet Gastroenterology & Hepatology

Self Cite

411

303

View full text Add to dashboard Cite

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“…However, some analysts have argued that this threshold is not valid for low‐income or mid‐income countries, and it should be lower for them . Thus, this paper used a conservative threshold of GDP‐per‐capita to define cost‐effectiveness and also to be consistent with previous studies in Korea …”

Section: Discussionmentioning

confidence: 87%

“…25 Thus, this paper used a conservative threshold of GDPper-capita to define cost-effectiveness and also to be consistent with previous studies in Korea. 26 A previous study from the USA on the cost-effectiveness of genotype 2 HCV therapeutics also showed that the comparative ICER of 12 weeks of SOF + RBV to 24 weeks of PR was $238 000 per QALY gained among treatment-naïve non-cirrhotic US patients, 27 which was not cost-effective. However, the comparative ICER of 12 weeks of SOF + RBV to 24 weeks of PR was $35 500 in cirrhotic patients and that of 16 weeks of SOF + RBV to 24 weeks of PR in treatment-experienced cirrhotic patients was $27 300, for which both cases were cost-effective.…”

Section: Discussionmentioning

confidence: 99%

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Cost‐effectiveness of sofosbuvir plus ribavirin therapy for hepatitis C virus genotype 2 infection in South Korea

Chung

Kim

Jang

et al. 2018

J of Gastro and Hepatol

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Background and Aim For genotype 2 chronic hepatitis C (CHC), the efficacy and safety of sofosbuvir plus ribavirin therapy (SOF + RBV) was better than pegylated interferon plus ribavirin therapy (PR) at a greater drug cost. This study investigated the cost‐effectiveness of SOF + RBV compared with PR for treatment‐naïve genotype 2 CHC in South Korea. Methods Using a decision analytic Markov model, a cost‐effectiveness analysis comparing SOF + RBV with PR or no treatment for treatment‐naïve genotype 2 CHC was performed with probabilistic and deterministic sensitivity analyses from the payer's perspective in 2017. Three cohorts of patients aged 40–49, 50–59, and 60–69 years were simulated to progress through the fibrosis stages F0–F4 to end‐stage liver disease, hepatocellular carcinoma, or death. Published and calculated data on the clinical efficacy of the regimen, health‐related quality of life, costs, and transition probabilities were used. Results While the incremental cost‐effectiveness ratio for PR was dominant over no treatment, the incremental cost‐effectiveness ratios for SOF + RBV were $20 058 for the patients in their 40s, $19 662 for those in their 50s, and $22 278 for those in their 60s compared with PR. Probabilistic sensitivity analysis indicated an 89.0% probability for the SOF + RBV to be cost‐effective at a willingness to pay of $29 754.4 (per‐capita gross domestic product in 2017) for the patients in their 40s and 94.1% and 89.1% for the patients in their 50s and 60s, respectively. Conclusions The SOF + RBV is a cost‐effective option for genotype 2 treatment‐naïve CHC patients, especially for the patients with liver cirrhosis in Korea.

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“…The cost‐effectiveness of HCV screening is sensitive to the prevalence of asymptomatic HCV infection, the acceptability of the screening and treatment, treatment and care costs and affordability . Although the CEA of HCV screening is necessary for each country, there have been only a few CEA studies in Asia …”

Section: Introductionmentioning

confidence: 99%

Cost‐effectiveness and health‐related outcomes of screening for hepatitis C in Korean population

Kim

Chung

Choi

et al. 2018

Liver International

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Estimating the Cost-Effectiveness of One-Time Screening and Treatment for Hepatitis C in Korea

Cited by 29 publications

References 38 publications

Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission

Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission

Cost‐effectiveness of sofosbuvir plus ribavirin therapy for hepatitis C virus genotype 2 infection in South Korea

Cost‐effectiveness and health‐related outcomes of screening for hepatitis C in Korean population

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