Cost-effectiveness of increased screening and treatment of chronic hepatitis C in Korea
- Authors
- Kim, Do Young; Wong, Gabriel; Lee, Janet; Kim, Myung Hwa; Smith, Nathaniel; Blissett, Rob; Kim, Hyung Joon
- Issue Date
- Jun-2020
- Publisher
- TAYLOR & FRANCIS LTD
- Keywords
- Hepatitis C; cost-effectiveness; cost-utility; ledipasvir; sofosbuvir; glecaprevir; pibrentasvir; South Korea
- Citation
- CURRENT MEDICAL RESEARCH AND OPINION, v.36, no.6, pp 993 - 1002
- Pages
- 10
- Journal Title
- CURRENT MEDICAL RESEARCH AND OPINION
- Volume
- 36
- Number
- 6
- Start Page
- 993
- End Page
- 1002
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/42840
- DOI
- 10.1080/03007995.2020.1756232
- ISSN
- 0300-7995
1473-4877
- Abstract
- Background: Given a hepatitis C virus (HCV) elimination goal by 2030, World Health Organization (WHO) guidelines recommend scaling up HCV screening and treatment with highly-effective direct-acting antivirals (DAAs). This study investigated the cost-effectiveness of various screening and treatment strategies for chronic HCV patients in South Korea in patients aged over 40 as compared to currently screening only high-risk patients. Methods: A published Markov disease progression model was used with a screening/treatment decision-tree to model different screening and treatment strategies for Korean HCV patients (aged over 40) from a national payer perspective over a lifetime time horizon. The screening strategies included "screen-all" (upfront only: "once"; or upfront and age 65: "twice") or a "high-risk only" screening strategy followed by treatment. Treatment strategies included either ledipasvir/sofosbuvir (LDV/SOF), SOF + ribavirin (SOF + RBV; in GT2 only), or glecaprevir/pibrentasvir (GLE/PIB). Model inputs were sourced from published literature and costing databases and validated by Korean hepatologists. Results: Regardless of treatment strategy, a "screen all twice" scenario led to the lowest rates of advanced liver disease events compared to "screen all once" and "high-risk only" screening scenarios. In this screening scenario, treatment with LDV/SOF for GT1/2 dominates (i.e. is more effective and less4costly) LDV/SOF in GT1 and SOF + RBV in GT2, while GLE/PIB is not cost-effective relative to LDV/SOF (& x20a9;105,124,920/QALY) at a willingness-to-pay threshold of 1xGDP per capita. Conclusion: Screening all South Korean patients twice followed by LDV/SOF treatment is cost-effective as compared current high-risk screening. Adopting this strategy can help achieve WHO HCV elimination goals.
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