Health benefits of antiviral therapy for mild chronic hepatitis C: randomised controlled trial and economic evaluation

Abstract

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Cost-effectiveness of non-invasive methods for assessment and monitoring of liver fibrosis and cirrhosis in patients with chronic liver disease: systematic review and economic evaluation

“…Wright et al 414 were unable to locate separate estimates of probabilities of progression from mild to moderate fibrosis disease stages health state from existing studies as they found that most data were based on retrospective natural history studies which do not use liver biopsy to stage fibrosis and progression. As the disease progression may not be linear, it may not be realistic to assume a constant rate of progression from mild fibrosis to cirrhosis, and so they estimated transition probabilities for mild and moderate health states using data from a trial of treatments for mild HCV undertaken in a number of London hospitals, 415 during which the liver fibrosis stage was determined by liver biopsy.…”

“…Resource use data on blood products used, number of dietitian sessions, drugs used, inpatient stay, nutritional support received, outpatient visits, physiotherapy sessions, tests, length of transplant operation and key treatments and investigations were collected. Based on the review, we concluded that the data on costs for treating HCV from the study by Wright et al 414 for the mild, moderate and cirrhotic health states would be comparable with the costs for treating patients with HBV in these health states, as the resource use identified and collected (inpatient, outpatient care, procedures) should be similar. The health state costs sourced from this study did not contain the cost of antiviral treatment; therefore, they were suitable to use and we added the cost of treatment separately in the model.…”

“…In the absence of transition probability data for these health states, we used data from a study in patients with mild chronic HCV. 414 This paper was identified in our review of data for our analysis of HCV but was also referenced as a source of cost data in the paper by Dakin et al 372 We adopted this approach with regard to early transition probabilities and this was confirmed as appropriate with clinical colleagues.…”

“…414,415 Detailed cost data were collected from three centres based in London, Newcastle and Southampton. Resource use information collected covered inpatient and outpatient care, investigations, procedures, drug use and other services including psychiatric services.…”

Surveillance of cirrhosis for hepatocellular carcinoma: a cost–utility analysis

“…For parameters in which there were no UK-based studies available, we sought data from countries with a similar disease profile. Cost data were obtained from national (UK NHS; Department of Health (DoH), 2005) sources where available, supplemented by data from a recent UK-based observational study of patients with HCV (Wright et al, 2006). Historical values were inflated to 2004 prices.…”