Cost-effectiveness of hepatitis C virus antiviral treatment for injection drug user populations

摘要: Injecting drug use is the main risk of hepatitis C virus (HCV) transmission in most developed countries. HCV antiviral treatment (peginterferon-α + ribavirin) has been shown to be cost-effective for patients with no reinfection risk. We examined cost-effectiveness providing injecting users (IDUs) as compared treating ex/non-IDUs or treatment. A dynamic model and disease progression was developed, incorporating: a fixed number treatments allocated at mild stage over 10 years, retreatment after failure, potential reinfection, three baseline IDU chronic prevalence scenarios (20%, 40%, 60%). performed probabilistic cost-utility analysis estimating long-term costs outcomes measured quality adjusted life years (QALYs) calculating incremental ratio (ICER) comparing IDUs, ex/non-IDUs, Antiviral IDUs option 20% 40% settings, ICERs £521 £2,539 per QALY saved, respectively. Treatment dominated these scenarios. At 60% prevalence, slightly more likely (with an ICER £6,803), due high reinfection. sensitivity indicates rankings hold even when sustained viral response rates are halved. Conclusion: Despite possibility suggests policy less than 60%. Further research on how injectors can scaled up its impact warranted. (HEPATOLOGY 2012)