Help
Subscribe


Submit Videos to GastroHep Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Birth cohort testing and treatment for HCV in the USA

July's issue of Hepatology investigates the impact of timing and prioritization on the cost-effectiveness of birth cohort testing and treatment for hepatitis C virus in the United States.

News image

Recent United States guidelines recommend one-time birth cohort testing for hepatitis C infection in persons born between 1945 and 1965.

This represents a major public health policy undertaking.

Dr Phil McEwan and colleagues from the United Kingdom assessed the role of treatment timing and prioritization on predicted cost-effectiveness.

The team used a MONARCH hepatitis C lifetime simulation model in conjunction with a testing and treatment decision tree to estimate the cost-effectiveness of birth cohort versus risk-based testing incorporating information on age, fibrosis stage and treatment timing.

The study used a 1945-1965 birth cohort and included disease progression, testing and treatment-related parameters.

Scenario analysis was used to evaluate the impact of hepatitis C virus prevalence, treatment eligibility, age, fibrosis stage and timing of treatment initiation on total costs, quality-adjusted life years, hepatitis C virus-related complications and cost-effectiveness.

Prioritizing treatment was associated with a decrease in a total cost of $7.5 billion
Hepatology

The researchers found the cost-effectiveness of birth cohort versus risk-based testing was $28,602.

Assuming 91% of the population is tested, at least 278,000 people need to be treated for birth cohort testing to maintain cost-effectiveness.

The team noted that prioritizing treatment toward those with more advanced fibrosis is associated with a decrease in a total cost of $7.5 billion, and 59,035 fewer hepatitis C virus-related complications.

Total quality-adjusted life years and complications avoided are maximized when treatment initiation occurs as soon as possible after testing.

Dr McEwan's team comments, "This study confirms that birth cohort testing is, on average, cost-effective."

"However, this remains true only when enough tested and hepatitis C virus-positive subjects are treated to generate sufficient cost offsets and quality-adjusted life years gains."

"Given the practical and financial challenges associated with implementing birth cohort testing, the greatest return on investment is obtained when eligible patients are treated immediately and those with more advanced disease are prioritized."

Hepatology 2013: 58(1): (5464)
22 July 2013

Go to top of page Email this page Email this page to a colleague

 01 February 2015

Advanced search
 30 January 2015 
HIV-associated NAFLD and primary NAFLD
 30 January 2015 
Narcotic use in children with IBD
 30 January 2015 
Removal of rectal neoplasms
 29 January 2015 
Gastric cancer in peptic ulcer disease
 29 January 2015 
Genetics and risk of Barrett's
 29 January 2015 
Pyloric compliance in gastroparesis
 28 January 2015 
Surgery and quality of life in rectal cancer
 28 January 2015 
Metabolic syndrome in celiac disease
 28 January 2015 
Remission in Crohn's disease
 27 January 2015 
Outcomes for liver transplantation
 27 January 2015 
Psychological distress and fecal composition in IBS
 27 January 2015 
Risk of upper GI cancers in GERD
 26 January 2015 
Breath analysis for IBD
 26 January 2015 
Fecal microbiota transplantation
 26 January 2015 
Antidepressants and GERD
 23 January 2015 
Liver transplant outcomes
 23 January 2015 
Breath analysis in IBD
 23 January 2015 
Fecal microbiota transplantation
 22 January 2015 
NASH and lipid improvements
 22 January 2015 
NAFLD and NASH with psoriasis
 22 January 2015 
Predicting outcomes in HCV-related advanced liver disease
 21 January 2015 
Colon capsule versus CT colonography
 21 January 2015 
Barrett's esophagus screening in the community
 21 January 2015 
Portal vein obstruction
 20 January 2015 
Modulating mucosal damage in Crohn's
 20 January 2015 
Novel techniques for Barrett's screening
 20 January 2015 
Food intolerance
 19 January 2015 
Treatment of fecal incontinence
 19 January 2015 
Hepatic cyst infection
 19 January 2015 
Risk of IBS among relatives
 16 January 2015 
Colorectal cancer screening uptake
 16 January 2015 
NAFLD and NASH in patients with psoriasis
 16 January 2015 
Fecal incontinence
 15 January 2015 
Coffee intake and liver disease
 15 January 2015 
NAFLD in primary care practice
 15 January 2015 
Management of univestigated dyspepsia
 14 January 2015 
Missed colorectal cancers after colonoscopy with polypectomy
 14 January 2015 
Inflixmab response in Crohn's
 14 January 2015 
Statins and liver injury in chronic liver disease
 13 January 2015 
Cytomegalovirus in IBD
 13 January 2015 
Helicobacter-negative gastritis
 13 January 2015 
Hep B vaccine in IBD
 12 January 2015 
Survival in Hep B virus-related hepatocellular carcinoma
 12 January 2015 
Relapse of Crohn's disease after surgery
 12 January 2015 
Late liver metastases of colorectal cancer
 09 January 2015 
Fecal microbiota transplantation for refractory Crohn's
 09 January 2015 
Hypercoagulability after liver resection
 09 January 2015 
Naps and gastroesophageal reflux vs nocturnal sleep
 08 January 2015 
Post-infectious functional dyspepsia
 08 January 2015 
Diagnosis of liver iron overload
 08 January 2015 
Digestive tract damage in Crohn's disease
 07 January 2015 
Early-onset colorectal cancer
 07 January 2015 
SSRIs for noncardiac chest pain
 07 January 2015 
SSRIs and upper GI bleeds
 06 January 2015 
Detection of inflammation in Crohn's
 06 January 2015 
Leptin and early-onset extreme obesity
 06 January 2015 
Goals of IBD treatment
 19 December 2014 
Thiopurine treatment and colectomy in ulcerative colitis
 19 December 2014 
Idiopathic inflammatory demyelinating disease in IBD
 19 December 2014 
Colorectal cancer risk for first-degree relatives

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2015 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us