Cost-Effectiveness of Strategies to Identify Children with Perinatally Acquired Hepatitis C Infection - 05/07/23
, Lakshmi Panagiotakopoulos, MD 2, Carolyn Wester, MD 2, Noele Nelson, MD 2, Amy L. Sandul, DHSc 2Abstract |
Objective |
To determine the optimal testing strategy to identify children with perinatally acquired hepatitis C virus (HCV) infection.
Study design |
We used a decision-tree framework with a Markov disease progression model to conduct an economic analysis of 4 strategies, based on combinations of type and timing of test: anti-HCV with reflex to HCV RNA at 18 months among children known to be perinatally exposed (ie, baseline comparison strategy); HCV RNA testing at 2-6 months among infants known to be perinatally exposed (test strategy 1); universal anti-HCV with reflex to HCV RNA at 18 months among all children (test strategy 2); and universal HCV RNA testing at 2-6 months among all infants (test strategy 3). We estimated total cost, quality-adjusted life years, and disease sequalae for each strategy.
Results |
Each of the 3 alternative testing strategies resulted in an increased number of children tested and improved health outcomes. HCV RNA testing at 2-6 months (test strategy 1) was cost-saving and resulted in a population-level difference in cost of $469 671. The 2 universal testing strategies resulted in an increase in quality-adjusted life years and an increase in total costs.
Conclusions |
Testing of perinatally exposed infants at age 2-6 months with a single HCV RNA test will reduce costs and improve health outcomes, preventing morbidity and mortality associated with complications from perinatal HCV infections.
Le texte complet de cet article est disponible en PDF.Keywords : hepatitis C virus, diagnosis, economic evaluation, maternal antibodies
Abbreviations : anti-HCV, HCV, ICER, QALY
Plan
| This work was supported by the National Center for HIV, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, as part of the NCHHSTP Epidemiologic and Economic Modeling Cooperative Agreement (grant number: 5U38PS004650). EH reports receiving consulting fees from Merck & Co. for work unrelated to this research. LP, NN, CW, and AS report salaries as employees at the US Centers for Disease Control and Prevention. All other authors have no conflicts of interest to disclose. |
|
| The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention or the authors affiliated institutions. There are no previous publications or submissions with any overlapping information, including studies and patients. |
Vol 258
Article 113409- juillet 2023 Retour au numéro
Article précédent
- Combining Panel-Based Next-Generation Sequencing and Exome Sequencing for Genetic Liver Diseases
- Chi-Bo Chen, Jacob Shujui Hsu, Pei-Lung Chen, Jia-Feng Wu, Huei-Ying Li, Bang-Yu Liou, Mei-Hwei Chang, Yen-Hsuan Ni, Wuh-Liang Hwu, Yin-Hsiu Chien, Yen-Yin Chou, Yao-Jong Yang, Ni-Chung Lee, Huey-Ling Chen
- HIV Incidence and Death Among Orphaned and Nonorphaned Children and Adolescents Living in Family-Based Settings in Western Kenya: A Prospective Cohort Analysis
- Dorothy Apedaile, Allison DeLong, Edwin Sang, David Ayuku, Lukoye Atwoli, Omar Galárraga, Joseph Hogan, Paula Braitstein
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?