Title :

Assessing the cost-effectiveness of hepatitis C screening strategies in France.

Author(s) :

Burban, Sylvie [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Huneau, Alexandre [Auteur]
Infection, Anti-microbiens, Modélisation, Evolution [IAME (UMR_S_1137 / U1137)]
Verleene, Adeline [Auteur]
Infection, Anti-microbiens, Modélisation, Evolution [IAME (UMR_S_1137 / U1137)]
Brouard, Cecile [Auteur]
Santé publique France - French National Public Health Agency [Saint-Maurice, France]
Pillonel, Josiane [Auteur]
Santé publique France - French National Public Health Agency [Saint-Maurice, France]
Le Strat, Yann [Auteur]
Santé publique France - French National Public Health Agency [Saint-Maurice, France]
Cossais, Sabrina [Auteur]
Infection, Anti-microbiens, Modélisation, Evolution [IAME (UMR_S_1137 / U1137)]
Roudot-Thoraval, Francoise [Auteur]
CHU Henri Mondor [Créteil]
Canva, Valerie [Auteur]
Hôpital Claude Huriez [Lille]
Mathurin, Philippe [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Dhumeaux, Daniel [Auteur]
Molecular virology and immunology – Physiopathology and therapeutic of chronic viral hepatitis (Team 18) [Inserm U955]
Yazdanpanah, Yazdan [Auteur]
Infection, Anti-microbiens, Modélisation, Evolution [IAME (UMR_S_1137 / U1137)]
Canva, V [Auteur]

Journal title :

Journal of hepatology

Abbreviated title :

J. Hepatol.

Volume number :

69

Pages :

785-792

Publication date :

2018-10-01

ISSN :

1600-0641

Keyword(s) :

Cost-effectiveness analysis
Screening
Interferon-free direct-acting antiviral agents
Chronic hepatitis C
Cohort Markov model
Effectiveness analysis

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

BACKGROUND & AIMS: In Europe, hepatitis C virus (HCV) screening still targets people at high risk of infection. We aim to determine the cost-effectiveness of expanded HCV screening in France. METHODS: A Markov model simulated ...
Show more >BACKGROUND & AIMS: In Europe, hepatitis C virus (HCV) screening still targets people at high risk of infection. We aim to determine the cost-effectiveness of expanded HCV screening in France. METHODS: A Markov model simulated chronic hepatitis C (CHC) prevalence, incidence of events, quality-adjusted life years (QALYs), costs and incremental cost-effectiveness ratio (ICER) in the French general population, aged 18 to 80 years, undiagnosed for CHC for different strategies: S1 = current strategy targeting the at risk population; S2 = S1 and all men between 18 and 59 years; S3 = S1 and all individuals between 40 and 59 years; S4 = S1 and all individuals between 40 and 80 years; S5 = all individuals between 18 and 80 years (universal screening). Once CHC was diagnosed, treatment was initiated either to patients with fibrosis stage ≥F2 or regardless of fibrosis. Data were extracted from published literature, a national prevalence survey, and a previously published mathematical model. ICER were interpreted based on one or three times French GDP per capita (€32,800). RESULTS: Universal screening led to the lowest prevalence of CHC and incidence of events, regardless of treatment initiation. When considering treatment initiation to patients with fibrosis ≥F2, targeting all people aged 40-80 was the only cost-effective strategy at both thresholds (€26,100/QALY). When we considered treatment for all, although universal screening of all individuals aged 18-80 is associated with the highest costs, it is more effective than targeting all people aged 40-80, and cost-effective at both thresholds (€31,100/QALY). CONCLUSIONS: In France, universal screening is the most effective screening strategy for HCV. Universal screening is cost-effective when treatment is initiated regardless of fibrosis stage. From an individual and especially from a societal perspective of HCV eradication, this strategy should be implemented. LAY SUMMARY: In the context of highly effective and well tolerated therapies for hepatitis C virus that are now recommended for all patients, a reassessment of hepatitis C screening strategies is needed. An effectiveness and cost-effectiveness study of different strategies targeting either the at-risk population, specific ages or all individuals was performed. In France, universal screening is the most effective strategy and is cost-effective when treatment is initiated regardless of fibrosis stage. From an individual and especially from a societal perspective of hepatitis C virus eradication, this strategy should be implemented.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Inserm
Université de Lille
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Research team(s) :

Inflammatory digestive disease : pathophysiology and therapeutic targets developement
Nutritional modulation of inflammation and infection

Submission date :

2019-03-01T14:35:22Z
2024-01-19T12:50:15Z