23 research outputs found
Economic consequences of investing in anti-HCV antiviral treatment from the Italian NHS perspective : a real-world-based analysis of PITER data
OBJECTIVE:
We estimated the cost consequence of Italian National Health System (NHS) investment in direct-acting antiviral (DAA) therapy according to hepatitis C virus (HCV) treatment access policies in Italy.
METHODS:
A multistate, 20-year time horizon Markov model of HCV liver disease progression was developed. Fibrosis stage, age and genotype distributions were derived from the Italian Platform for the Study of Viral Hepatitis Therapies (PITER) cohort. The treatment efficacy, disease progression probabilities and direct costs in each health state were obtained from the literature. The break-even point in time (BPT) was defined as the period of time required for the cumulative costs saved to recover the Italian NHS investment in DAA treatment. Three different PITER enrolment periods, which covered the full DAA access evolution in Italy, were considered.
RESULTS:
The disease stages of 2657 patients who consecutively underwent DAA therapy from January 2015 to December 2017 at 30 PITER clinical centres were standardized for 1000 patients. The investment in DAAs was considered to equal âŹ25 million, âŹ15 million, and âŹ9 million in 2015, 2016, and 2017, respectively. For patients treated in 2015, the BPT was not achieved, because of the disease severity of the treated patients and high DAA prices. For 2016 and 2017, the estimated BPTs were 6.6 and 6.2 years, respectively. The total cost savings after 20 years were âŹ50.13 and âŹ55.50 million for 1000 patients treated in 2016 and 2017, respectively.
CONCLUSIONS:
This study may be a useful tool for public decision makers to understand how HCV clinical and epidemiological profiles influence the economic burden of HCV
L'Italia come modello per l'Europa e per il mondo nelle politiche sanitarie per il trattamento dell'epatite cronica da HCV
The World Health Organization foresees the
elimination of HCV infection by 2030. In light of this and the curre
nt, nearly worldwide, restriction in direct-acting agents
(DAA) accessibility due to their high price, we aimed to evaluate
the cost-effectiveness of two alternative DAA treatment
policies: Policy 1 (universal): treat all patients, regardless of the fibrosis stage; Policy 2 (prioritized): treat only priori
tized
patients and delay treatment of the
remaining patients until reaching stage F3. T
he model was based on patientâs data
from the PITER cohort. We demonstrated that extending HC
V treatment of patients in any fibrosis stage improves health
outcomes and is cost-effective
Corrigendum to \u201cPremature ovarian senescence and a high miscarriage rate impair fertility in women with HCV\u201d [J Hepatol 68 (2018) 33\u201341](S0168827817322596)(10.1016/j.jhep.2017.08.019)
It has come to our attention that the PITER framework investigator, Alessandro Federico, was incorrectly listed as F. Alessandro in the original manuscript. Please note that the correct name of this author is Alessandro Federico (2nd University of Naples). The correct list of PITER investigators is in the footnote below