3 research outputs found
Cost and costâeffectiveness of a simplified treatment model with directâacting antivirals for chronic hepatitis C in Cambodia
Background & Aims
In 2016, MĂ©decins Sans FrontiĂšres established the first general population Hepatitis C virus (HCV) screening and treatment site in Cambodia, offering free directâacting antiviral (DAA) treatment. This study analysed the costâeffectiveness of this intervention.
Methods
Costs, quality adjusted life years (QALYs) and costâeffectiveness of the intervention were projected with a Markov model over a lifetime horizon, discounted at 3%/year. Patientâlevel resourceâuse and outcome data, treatment costs, costs of HCVârelated healthcare and EQâ5Dâ5L health states were collected from an observational cohort study evaluating the effectiveness of DAA treatment under full and simplified models of care compared to no treatment; other model parameters were derived from literature. Incremental costâeffectiveness ratios (cost/QALY gained) were compared to an opportunity costâbased willingnessâtoâpay threshold for Cambodia (925(IQR 376(IQR 187/QALY), cost an additional $14 485/QALY compared to the simplified model, above the willingnessâtoâpay threshold for Cambodia. This result is robust to variation in parameters.
Conclusions
The simplified model of care was cost saving compared to no treatment, emphasizing the importance of simplifying pathways of care for improving access to HCV treatment in lowâresource settings