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Economic study of the value of expanding HCV treatment capacity in Germany

BACKGROUND: Today's highly efficacious, low-toxicity interferon-free treatment regimens for chronic hepatitis C virus (HCV) can cure most patients with HCV in 12–24 weeks. The aim of this study was to understand how the introduction of shorter duration treatment regimens for HCV will impact the...

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Autores principales: Sbarigia, Urbano, Wirth, Daniel, Van Nuys, Karen, Huber, Caroline, Brookmeyer, Ron, Stahmeyer, Jona, Krauth, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5387957/
https://www.ncbi.nlm.nih.gov/pubmed/28461903
http://dx.doi.org/10.1136/bmjgast-2016-000130
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author Sbarigia, Urbano
Wirth, Daniel
Van Nuys, Karen
Huber, Caroline
Brookmeyer, Ron
Stahmeyer, Jona
Krauth, Christian
author_facet Sbarigia, Urbano
Wirth, Daniel
Van Nuys, Karen
Huber, Caroline
Brookmeyer, Ron
Stahmeyer, Jona
Krauth, Christian
author_sort Sbarigia, Urbano
collection PubMed
description BACKGROUND: Today's highly efficacious, low-toxicity interferon-free treatment regimens for chronic hepatitis C virus (HCV) can cure most patients with HCV in 12–24 weeks. The aim of this study was to understand how the introduction of shorter duration treatment regimens for HCV will impact the capacity for treatment and value to society. METHODS: A Markov model of HCV transmission and progression was constructed, incorporating nationally representative data on HCV prevalence, incidence and progression; mortality, treatment costs, medical expenditures, employment probabilities and disability payments in Germany. The model was stratified by HCV genotype and exposure route (1-time healthcare exposure, injection drug use and sexual activity). Treatment scenarios were based on German treatment guidelines and projected treatment capacity. The impact of different treatment scenarios on disease transmission and prevalence, quality-adjusted life years (QALYs), treatment costs, medical expenditures, employment and disability expenditures was calculated. RESULTS: Depending on their adoption profile, new treatment regimens and protocols introduced over the next several years will increase HCV treatment capacity in Germany by 8–30%, reducing disease transmission and prevalence, increasing QALYs and adding €94–310 million in discounted social value (QALYs plus medical savings net of treatment costs) over a 30-year horizon. Additional social value in the form of higher employment and lower disability would also result. CONCLUSIONS: The introduction of shorter HCV treatment regimens and the resulting increased treatment capacity in Germany would result in large gains to society by reducing disease transmission and prevalence, resulting in longer, healthier, more productive lives for current and future generations.
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spelling pubmed-53879572017-05-01 Economic study of the value of expanding HCV treatment capacity in Germany Sbarigia, Urbano Wirth, Daniel Van Nuys, Karen Huber, Caroline Brookmeyer, Ron Stahmeyer, Jona Krauth, Christian BMJ Open Gastroenterol Hepatology BACKGROUND: Today's highly efficacious, low-toxicity interferon-free treatment regimens for chronic hepatitis C virus (HCV) can cure most patients with HCV in 12–24 weeks. The aim of this study was to understand how the introduction of shorter duration treatment regimens for HCV will impact the capacity for treatment and value to society. METHODS: A Markov model of HCV transmission and progression was constructed, incorporating nationally representative data on HCV prevalence, incidence and progression; mortality, treatment costs, medical expenditures, employment probabilities and disability payments in Germany. The model was stratified by HCV genotype and exposure route (1-time healthcare exposure, injection drug use and sexual activity). Treatment scenarios were based on German treatment guidelines and projected treatment capacity. The impact of different treatment scenarios on disease transmission and prevalence, quality-adjusted life years (QALYs), treatment costs, medical expenditures, employment and disability expenditures was calculated. RESULTS: Depending on their adoption profile, new treatment regimens and protocols introduced over the next several years will increase HCV treatment capacity in Germany by 8–30%, reducing disease transmission and prevalence, increasing QALYs and adding €94–310 million in discounted social value (QALYs plus medical savings net of treatment costs) over a 30-year horizon. Additional social value in the form of higher employment and lower disability would also result. CONCLUSIONS: The introduction of shorter HCV treatment regimens and the resulting increased treatment capacity in Germany would result in large gains to society by reducing disease transmission and prevalence, resulting in longer, healthier, more productive lives for current and future generations. BMJ Publishing Group 2017-04-04 /pmc/articles/PMC5387957/ /pubmed/28461903 http://dx.doi.org/10.1136/bmjgast-2016-000130 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Hepatology
Sbarigia, Urbano
Wirth, Daniel
Van Nuys, Karen
Huber, Caroline
Brookmeyer, Ron
Stahmeyer, Jona
Krauth, Christian
Economic study of the value of expanding HCV treatment capacity in Germany
title Economic study of the value of expanding HCV treatment capacity in Germany
title_full Economic study of the value of expanding HCV treatment capacity in Germany
title_fullStr Economic study of the value of expanding HCV treatment capacity in Germany
title_full_unstemmed Economic study of the value of expanding HCV treatment capacity in Germany
title_short Economic study of the value of expanding HCV treatment capacity in Germany
title_sort economic study of the value of expanding hcv treatment capacity in germany
topic Hepatology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5387957/
https://www.ncbi.nlm.nih.gov/pubmed/28461903
http://dx.doi.org/10.1136/bmjgast-2016-000130
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