1. Systematic review: economic evaluations of HCV screening in the direct-acting antivirals era.
- Author
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Cortesi PA, Barca R, Giudicatti G, Mossini S, Ciaccio A, Iannazzo S, Micale M, Cesana G, and Mantovani LG
- Subjects
- Cost-Benefit Analysis, Drug Costs, Hepacivirus isolation & purification, Hepatitis C economics, Hepatitis C epidemiology, Hepatitis C, Chronic diagnosis, Hepatitis C, Chronic drug therapy, Hepatitis C, Chronic economics, Hepatitis C, Chronic epidemiology, Humans, Mass Screening methods, Mass Screening statistics & numerical data, Mass Screening trends, Quality-Adjusted Life Years, Risk Factors, Antiviral Agents economics, Antiviral Agents therapeutic use, Hepatitis C diagnosis, Hepatitis C drug therapy, Mass Screening economics
- Abstract
Background: The World Health Organization estimated that 90% of the infected people need to be diagnosed and 80% need to be treated to reach the aim of hepatitis C virus (HCV) elimination by 2030. For this reason, all possible strategies to detect and treat HCV-infected people need to be carefully evaluated to implement the best one., Aim: To review and synthesise the economic evaluations of HCV screening programs conducted in the era of direct-acting antiviral agents regimens., Methods: A systematic literature review was conducted until April 2018 to provide information on the costs and effectiveness of HCV screenings in direct-acting antiviral agents era. A critical assessment of the quality of economic evaluations retrieved was conducted., Results: The literature search identified 716 references; 17 of them assessed cost and effectiveness of screening programs and antiviral treatments in different populations: general population (n = 7), drug users (n = 5), high-risk populations (n = 4) and other populations (n = 3). The HCV screening and direct-acting antiviral agents treatment appear to be good value for money, both in general and high-risk populations, if a cost per quality adjusted life years of $50 000 is set as willingness to pay threshold. Some studies showed the value of including lower stage of fibrosis in the treatment selection criteria., Conclusions: Several HCV screening strategies plus direct-acting antiviral agents treatments resulted cost-effectiveness in different populations. However, there is still need of country and population-specific evaluations within the different HCV screening and treatment strategies available, in order to assess their cost-effectiveness and sustainability and fully support an evidence-informed policy for HCV elimination., (© 2019 John Wiley & Sons Ltd.)
- Published
- 2019
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