Projections of the Healthcare Costs and Disease Burden due to Hepatitis C Infection under Different Treatment Policies in Malaysia, 2018–2040

McDonald, Scott; Azzeri, Amirah; Shabaruddin, Fatiha Hana; Dahlui, Maznah; Tan, Soek Siam; Kamarulzaman, Adeeba; Mohamed, Rosmawati

doi:10.1007/s40258-018-0425-3

Cited by 10 publications

(11 citation statements)

References 14 publications

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“…Malaysia, along with many countries dealing with competing priorities and resource constraints, is looking for opportunities to scaling up the use of DAAs. Although exorbitant drug costs used to pose a substantial financial challenge to Malaysia [ 27 , 28 ], budgetary pressure was not cited as a barrier to scaling up HCV treatment in this study. It was reaffirmed by the study participants that sufficient financial support for HCV care had been received from the government over the years.…”

Section: Discussionmentioning

confidence: 99%

Barriers to scaling up hepatitis C treatment in Malaysia: a qualitative study with key stakeholders

et al. 2022

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Background While the availability of generic direct-acting antivirals (DAAs) opens the door for large-scale treatment, the care for people living with hepatitis C virus (HCV) in Malaysia is shifting toward a tripartite partnership between the public health system, correctional settings and civil society organizations (CSOs). This study aimed to explore the barriers to scaling up HCV treatment in Malaysia from the perspective of key stakeholders. Methods Eighteen focus-group discussions (FGDs) were conducted with 180 individuals, who actively engaged in coordinating, executing or supporting the implementation of the national strategic plan for HCV. An analytical framework was adapted to guide the data collection and thematic analysis. It covered four key aspects of HCV treatment: geographical accessibility, availability, affordability and acceptability. Results Movement restrictions in times of coronavirus disease 2019 (COVID-19) outbreaks and being marginalized translated into barriers to treatment access in people living with HCV. Barriers to treatment initiation in health and correctional settings included limited staffing and capacity; disruption in material supply; silos mentality and unintegrated systems; logistical challenges for laboratory tests; and insufficient knowledge of care providers. Although no-cost health services were in place, concerns over transportation costs and productivity loss also continued to suppress the treatment uptake. Limited disease awareness, along with the disease-related stigma, further lowered the treatment acceptability. Conclusions This study disclosed a series of supply- and demand-side barriers to expanding the treatment coverage among people living with HCV in Malaysia. The findings call for strengthening inter-organizational collaborations to overcome the barriers.

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Section: Discussionmentioning

confidence: 99%

Barriers to scaling up hepatitis C treatment in Malaysia: a qualitative study with key stakeholders

et al. 2022

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“…Rates of hepatitis B infections have increased almost 5-fold from 2.26 of 100 000 in 2010 to 12.65 of 100 000 in 2015 and rates continue to increase. 30 Patients (30.5%) in a Malaysian cohort were reported to have genotype C (compared to 69.5% with genotype B). Genotype C along with genotype D carries a higher risk for developing cirrhosis and HCC.…”

Section: Current Demand and Burden Of End-stage Liver Disease In Mala...mentioning

confidence: 96%

Liver Transplantation in Malaysia: Needs, Obstacles, and Opportunities

et al. 2021

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“…Both number and characteristics of hepatitis C patients in care and number of patients receiving DAA treatment were derived from series of modeling studies (11,17,18). The numbers were estimated for all disease stages relevant to HCV, which include non-cirrhotic chronic infection (NCCI), compensated cirrhosis (CC), decompensated cirrhosis (DC), and hepatocellularcarcinoma (HCC).…”

Section: Number and Characteristics Of Hepatitis C Patients In Care A...mentioning

confidence: 99%

“…Following findings from both studies (17,18), the third modeling work was conducted to estimate the annual number and characteristics of patients in clinical care and the number of patient initiated DAA treatment in Malaysia (11). The recent modeling work projected the number of patients within care, annual numbers of patients initiated on antiviral treatment, and distribution of treatments for eligible stages of liver disease, for four possible treatment scenarios: (a) no antiviral treatment offered; (b) previous antiviral treatment with PEGINF/RBV; (c) scale-up in DAA treatment uptake deemed achievable, but not meeting the global treatment uptake target set by World Health Organization (WHO); and (d) scale-up in DAA treatment meeting the global treatment target set by WHO (11). For the purpose of this BIA analysis, scenario (c) was selected in line with the MoH's goals for hepatitis C treatment in Malaysia (10).…”

Section: Number and Characteristics Of Hepatitis C Patients In Care A...mentioning

confidence: 99%

Budget impact analysis of two treatment approaches for hepatitis C in Malaysia through the use of voluntary and compulsory licensing options

Azzeri

Dahlui²,

Mohamed³

et al. 2023

Front. Public Health

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IntroductionA scaled-up treatment cascade with direct-acting antiviral (DAA) therapy is necessary to achieve global WHO targets for hepatitis C virus (HCV) elimination in Malaysia. Recently, limited access to sofosbuvir/daclatasvir (SOF/DAC) is available through compulsory licensing, with access to sofosbuvir/velpatasvir (SOF/VEL) expected through voluntary licensing due to recent agreements. SOF/VEL has superior clinical outcomes but has higher drug acquisition costs compared to SOF/DAC. A stratified treatment cascade might be the most cost-efficient approach for Malaysia whereby all HCV patients are treated with SOF/DAC except for patients with cirrhosis who are treated with SOF/VEL.MethodsThis study aimed to conduct a 5-year budget impact analysis of the proposed stratified treatment cascade for HCV treatment in Malaysia. A disease progression model that was developed based on model-predicted HCV epidemiology data was used for the analysis, where all HCV patients in scenario A were treated with SOF/DAC for all disease stages while in scenario B, SOF/DAC was used only for non-cirrhotic patients and SOF/VEL was used for the cirrhotic patients. Healthcare costs associated with DAA therapy and disease stage monitoring were included to estimate the downstream cost implications.ResultsThe stratified treatment cascade with 109 in Scenario B was found to be cost-saving compared to Scenario A. The cumulative savings for the stratified treatment cascade was USD 1.4 million over 5 years.DiscussionA stratified treatment cascade with SOF/VEL was expected to be cost-saving and can result in a budget impact reduction in overall healthcare expenditure in Malaysia.

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Projections of the Healthcare Costs and Disease Burden due to Hepatitis C Infection under Different Treatment Policies in Malaysia, 2018–2040

Abstract: The scale-up to meet the WHO 2030 target may be achievable with appropriately high governmental commitment to the expansion of HCV screening to bring sufficient undiagnosed chronically infected patients into the treatment pathway.

Cited by 10 publications

References 14 publications

Barriers to scaling up hepatitis C treatment in Malaysia: a qualitative study with key stakeholders

Barriers to scaling up hepatitis C treatment in Malaysia: a qualitative study with key stakeholders

Liver Transplantation in Malaysia: Needs, Obstacles, and Opportunities

Budget impact analysis of two treatment approaches for hepatitis C in Malaysia through the use of voluntary and compulsory licensing options

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