Health state utilities associated with attributes of treatments for hepatitis C

BACKGROUND: Cost-utility analyses are frequently conducted to compare treatments for hepatitis C, which are often associated with complex regimens and serious adverse events. Thus, the purpose of this study was to estimate the utility associated with treatment administration and adverse events of hepatitis C treatments. DESIGN: Health states were drafted based on literature review and clinician interviews. General population participants in the UK valued the health states in time trade-off (TTO) interviews with 10- and 1-year time horizons. The 14 health states described hepatitis C with variations in treatment regimen and adverse events. RESULTS: A total of 182 participants completed interviews (50 % female; mean age = 39.3 years). Utilities for health states describing treatment regimens without injections ranged from 0.80 (1 tablet) to 0.79 (7 tablets). Utilities for health states describing oral plus injectable regimens were 0.77 (7 tablets), 0.75 (12 tablets), and 0.71 (18 tablets). Addition of a weekly injection had a disutility of −0.02. A requirement to take medication with fatty food had a disutility of −0.04. Adverse events were associated with substantial disutilities: mild anemia, −0.12; severe anemia, −0.32; flu-like symptoms, −0.21; mild rash, −0.13; severe rash, −0.48; depression, −0.47. One-year TTO scores were similar to these 10-year values. CONCLUSIONS: Adverse events and greater treatment regimen complexity were associated with lower utility scores, suggesting a perceived decrease in quality of life beyond the impact of hepatitis C. The resulting utilities may be used in models estimating and comparing the value of treatments for hepatitis C. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s10198-014-0649-6) contains supplementary material, which is available to authorized users

Fully Integrated Power Management Unit (PMU) Using NMOS Low Dropout Regulators

International audienc

Hydrological and Agricultural Impacts of Climate Change in the Vu Gia-Thu Bon River Basin in Central Vietnam

This paper summarizes some of the climate (change) impact modeling activities conducted in the Land useandClimate Changeinteractionsin Central Vietnam (LUCCi)project. The study area is the Vu Gia-Thu Bon (VGTB) river basin in Central Vietnam, which is characterized by recurrent floods during the rainy season, but also water shortages during the dry season. The impact modeling activities, such as the validation of the models are hindered by the scarcity of hydrometeorological data and an unfavorable distribution of the observation network, i.e., station data is available only for the lowlands. In total, two different process-based and distributed hydrological models are applied in concert with climate change and land use projections. Based on that, the magnitudes and return periods of extreme flows are estimated. The modeling results suggest increases of extreme high flows due to climate change. A multi-objective agro-economical model was developed for a typical irrigation scheme in the region in order to optimize the area for cropping, irrigation-techniques and schedules. The model results suggest the irrigation technique Alternate Wetting and Drying, which has the potential to increase the benefits for the farmers and help to mitigate greenhouse gases at the same time. In addition, the regional-scale crop model GLAM is applied for groundnut under rainfed conditions, which is capable to identify regions suitable for cropping in the future. The paper further synthesizes recommendations for local stakeholders in Central Vietnam.<br/