4 years ago

Should we treat acute hepatitis C? A decision and cost-effectiveness analysis.

Raymond T Chung, Chin Hur, Jagpreet Chhatwal, Qiushi Chen, Emily Bethea
It is not standard practice to treat patients with acute hepatitis C virus (HCV) infection. However, as the incidence of HCV in the United States continues to rise, it may be time to re-evaluate acute HCV management in the era of direct-acting antiviral agents (DAAs). In this study a microsimulation model was developed to analyze the tradeoffs between initiating HCV therapy in the acute versus chronic phase of infection. By simulating the lifetime clinical course of patients with acute HCV infection, we were able to project long-term outcomes such as quality-adjusted life years (QALYs) and costs. We found that treating acute HCV versus deferring treatment until the chronic phase increased QALYs by 0.02 and increased costs by $483 in patients not at risk of transmitting HCV. The resulting incremental cost effectiveness ratio (ICER) was $19,991 per QALY, demonstrating that treatment of acute HCV was cost-effective using a willingness-to-pay threshold of $100,000 per QALY. In patients at risk of transmitting HCV, treating acute HCV became cost-saving, increasing QALYs by 0.03 and decreasing costs by $3655.

Publisher URL: http://doi.org/10.1002/hep.29611

DOI: 10.1002/hep.29611

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