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Cost-effectiveness of community-based screening and treatment for chronic hepatitis B in The Gambia: an economic modelling analysis

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اقرأ أكثر حفظ في قائمتي
  • معلومة اضافية
    • Contributors:
      Department of Infectious Disease Epidemiology London (DIDE); Imperial College London; Barcelona Centre for International Health Research, Hospital Clinic (CRESIB); Universitat de Barcelona (UB); Medical Research Council Unit The Gambia (MRC); Epidémiologie des Maladies Emergentes - Emerging Diseases Epidemiology; Pasteur-Cnam Risques infectieux et émergents (PACRI); Institut Pasteur Paris (IP)-Conservatoire National des Arts et Métiers CNAM (CNAM)-Institut Pasteur Paris (IP)-Conservatoire National des Arts et Métiers CNAM (CNAM); Centre International de Recherche contre le Cancer - International Agency for Research on Cancer (CIRC - IARC); Organisation Mondiale de la Santé / World Health Organization Office Genève, Suisse (OMS / WHO); We thank the European Commission (FP7) for funding the programme; the Medical Research Council Laboratories, The Gambia Unit, the local ministry of health and social welfare, and the national public health laboratories for supporting the project.; We acknowledge the support of the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) who jointly fund (under the MRC/DFID Concordat agreement) the clinical research fellowship that supports SN.; We also thank the French Research Agency on HIV/AIDS and viral hepatitis (ANRS) for supporting ML's work within the PROLIFICA project.; The PROLIFICA team; All the study participants; and Debbie Garside, the project manager of PROLIFICA; All authors acknowledge the support of the UK National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at Imperial College London for infrastructure support.
    • بيانات النشر:
      HAL CCSD
      Elsevier
    • الموضوع:
      2016
    • نبذة مختصرة :
      Erratum in :Correction to Lancet Glob Health 2016; 4: e568-78.Lancet Glob Health. 2016 Nov;4(11):e794. doi:10.1016/S2214-109X(16)30272-8. PMID: 27765292 ; International audience ; Background: Despite the high burden of hepatitis B virus (HBV) infection in sub-Saharan Africa, absence of widespread screening and poor access to treatment leads to most people remaining undiagnosed until later stages of disease when prognosis is poor and treatment options are limited. We examined the cost-effectiveness of community-based screening and early treatment with antiviral therapy for HBV in The Gambia.Methods: In this economic evaluation, we combined a decision tree with a Markov state transition model to compare a screen and treat intervention consisting of adult community-based screening using a hepatitis B surface antigen (HBsAg) rapid test and subsequent HBV antiviral therapy versus current practice, in which there is an absence of publicly provided screening or treatment for HBV. We used data from the PROLIFICA study to parameterise epidemiological, primary screening, and cost information, and other model parameter inputs were obtained from a literature search. Outcome measures were cost per disability-adjusted life-year (DALY) averted; cost per life-year saved; and cost per quality-adjusted life-year (QALY) gained. We calculated the incremental cost-effectiveness ratios (ICERs) between current practice and the screen and treat intervention. Costs were assessed from a health provider perspective. Costs (expressed in 2013 US$) and health outcomes were discounted at 3% per year.Findings: In The Gambia, where the prevalence of HBsAg is 8·8% in people older than 30 years, adult screening and treatment for HBV has an incremental cost-effectiveness ratio (ICER) of $540 per DALY averted, $645 per life-year saved, and $511 per QALY gained, compared with current practice. These ICERs are in line with willingness-to-pay levels of one times the country's gross domestic product per capita ($487) per DALY averted, and remain robust ...
    • Relation:
      info:eu-repo/semantics/altIdentifier/pmid/27765292; PUBMED: 27765292
    • الرقم المعرف:
      10.1016/S2214-109X(16)30101-2
    • الدخول الالكتروني :
      https://pasteur.hal.science/pasteur-02875275
      https://pasteur.hal.science/pasteur-02875275v1/document
      https://pasteur.hal.science/pasteur-02875275v1/file/Cost-effectiveness%20of%20community-based%20screening%20and%20treatment%20for%20chronic%20hepatitis%20B%20in%20The%20Gambia%20an%20economic%20modelling%20analysis.pdf
      https://doi.org/10.1016/S2214-109X(16)30101-2
    • Rights:
      http://creativecommons.org/licenses/by/ ; info:eu-repo/semantics/OpenAccess
    • الرقم المعرف:
      edsbas.E03F2A9D