Economic Impact of Universal Hepatitis C Virus Testing for Middle-Aged Adults Who Inject Drugs.
Economic Impact of Universal Hepatitis C Virus Testing for Middle-Aged Adults Who Inject Drugs.
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DOI：
10.1016/j.amepre.2022.08.016
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发表时间：
2023-01
影响因子：
5.5
通讯作者：
Park, Haesuk
中科院分区：
文献类型：
--
作者：
Jiang, Xinyi;Diaby, Vakaramoko;Vouri, Scott Martin;Lo-Ciganic, Weihsuan;Parker, Robert L.;Wang, Wei;Chang, Shao-Hsuan;Wilson, Debbie L.;Henry, Linda;Park, Haesuk
评估在美国商业保险中年注射吸毒者（PWID）中提供通用丙型肝炎病毒（HCV）检测的经济影响。本研究开发了一个动态的十年经济模型，从付款人的角度，预测中年成人PWID中与HCV检测相关的临床和经济结果。与HCV检测、直接作用抗病毒药物（DAA）和肝脏相关结局相关的成本（1）当前HCV检测率（即，8%）和（2）普遍的HCV检测率（即，100%）进行比较。在检测阳性的患者中，21%的无肝硬化患者和48%的肝硬化患者被认为开始DAA。进行敏感性分析以确定变量（例如：DAA药物费用，HCV检测费用，DAA治疗率）影响本研究的结论。 该模型预测，在10年期间，与目前的情况相比，普及HCV检测将使每个PWID的支付者的医疗保健预算增加242美元。敏感性分析表明，在所有不同的参数和情景下，价值从增加1，656美元到节省1，085美元不等。80%的当前DAA成本表明，每个PWID的成本节约将达到383美元。在PWID中进行普遍的HCV检测不会在10年内实现成本节约，DAA的成本对支出贡献最大。为了促进艾滋病患者普遍进行HCV检测，应考虑降低DAA成本和可持续的HCV检测资金流。
To estimate the economic impact of providing universal hepatitis C virus (HCV) testing in commercially insured middle aged persons who inject drugs (PWIDs) in the United States. This study developed a dynamic ten-year economic model to project the clinical and economic outcomes associated with HCV testing among middle aged adult PWIDs, from a payer’s perspective. Costs related to HCV testing, direct-acting antiviral (DAA), and liver-related outcomes between the (1) current HCV testing rate (i.e., 8%) and (2) universal HCV testing rate (i.e., 100%) were compared. Among patients testing positive, 21% of those without cirrhosis and 48% with cirrhosis were assumed to initiate DAAs. Sensitivity analyses were performed to identify variables (e.g.: DAA drugs costs, HCV testing costs, DAA treatment rate) influencing this study’s conclusion. The model predicts that during the 10-year period, universal HCV testing will cost an additional $242 per PWID to the payers’ health care budgets compared to the current scenario. Sensitivity analyses demonstrated values ranging from $1,656 additional costs to $1,085 cost savings across all varied parameters and scenarios. 80% of the current DAA costs indicated that cost savings will be $383 per PWID. Universal HCV testing among PWIDs would not achieve cost savings within 10 years, with the cost of DAAs contributing the most to the spending. To promote the universal HCV testing among PWIDs, decreasing DAA costs and sustainable funding streams for HCV testing should be considered.
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影响因子：
39.2
作者：
Liu S;Watcha D;Holodniy M;Goldhaber-Fiebert JD
通讯作者：
Goldhaber-Fiebert JD
影响因子：
2.1
作者：
Jiang X;Song HJ;Wang W;Henry L;Childs-Kean LM;Re VL 3rd;Park H
通讯作者：
Park H
药物使用障碍和慢性丙型肝炎患者使用直接作用抗病毒药物的相关医疗保健利用率和成本。
影响因子：
2.1
作者：
Jiang X;Vouri SM;Diaby V;Lo-Ciganic W;Parker R;Park H
通讯作者：
Park H
DOI：
10.1097/qai.0000000000001968
发表时间：
2019-09-01
影响因子：
3.6
作者：
Fanfair, Robyn Neblett;Shrestha, Ram K.;DeMaria, Alfred
通讯作者：
DeMaria, Alfred
影响因子：
5.5
作者：
Lin, Feng;Farnham, Paul G.;Sansom, Stephanie L.
通讯作者：
Sansom, Stephanie L.