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. 2017 Jan 6;12(1):e0167770.
doi: 10.1371/journal.pone.0167770. eCollection 2017.

Estimating the Cost-Effectiveness of One-Time Screening and Treatment for Hepatitis C in Korea

Do Young Kim  1 , Kwang-Hyub Han  1 , Byungyool Jun  2 , Tae Hyun Kim  3 , Sohee Park  3 , Thomas Ward  4 , Samantha Webster  4 , Phil McEwan  4   5
Affiliations

Estimating the Cost-Effectiveness of One-Time Screening and Treatment for Hepatitis C in Korea

Do Young Kim et al. PLoS One. .

Abstract

Background and aims: This study aims to investigate the cost-effectiveness of a one-time hepatitis C virus (HCV) screening and treatment program in South Korea where hepatitis B virus (HBV) prevails, in people aged 40-70, compared to current practice (no screening).

Methods: A published Markov model was used in conjunction with a screening and treatment decision tree to model patient cohorts, aged 40-49, 50-59 and 60-69 years, distributed across chronic hepatitis C (CHC) and compensated cirrhosis (CC) health states (82.5% and 17.5%, respectively). Based on a published seroepidemiology study, HCV prevalence was estimated at 0.60%, 0.80% and 1.53%, respectively. An estimated 71.7% of the population was screened. Post-diagnosis, 39.4% of patients were treated with a newly available all-oral direct-acting antiviral (DAA) regimen over 5 years. Published rates of sustained virologic response, disease management costs, transition rates and utilities were utilised.

Results: Screening resulted in the identification of 43,635 previously undiagnosed patients across all cohorts. One-time HCV screening and treatment was estimated to be cost-effective across all cohorts; predicted incremental cost-effectiveness ratios ranged from $5,714 to $8,889 per quality-adjusted life year gained. Incremental costs associated with screening, treatment and disease management ranged from $156.47 to $181.85 million USD; lifetime costs-offsets associated with the avoidance of end stage liver disease complications ranged from $51.47 to $57.48 million USD.

Conclusions: One-time HCV screening and treatment in South Korean people aged 40-70 is likely to be highly cost-effective compared to the current practice of no screening.

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Conflict of interest statement

The authors declare this commercial funder, Bristol-Myers Squibb Pharmaceuticals Ltd., along with any other relevant declarations relating to employment, consultancy, patents, products in development, marketed products, etc. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Markov model flow diagram.
Fig 2
Fig 2. Screening flow diagram showing the derivation of the number of patients screened and allocated treatment across all patient populations.
Fig 3
Fig 3. The number of events avoided and the incremental costs associated with a screening and treatment program.
Fig 4
Fig 4. The relationship between the cost-effectiveness of screening and treatment, the prevalence of HCV amongst the general population and the rate of therapy uptake post diagnosis.
See this image and copyright information in PMC

References

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