An intensive model of care for hepatitis C virus screening and treatment with direct‐acting antivirals in people who inject drugs in Nairobi, Kenya: a model‐based cost‐effectiveness analysis.
Background and aims: Hepatitis C virus (HCV) treatment is essential for eliminating HCV in people who inject drugs (PWID), but has limited coverage in resource‐limited settings. We measured the cost‐effectiveness of a pilot HCV screening and treatment intervention using directly observed therapy amo...
| Publicado en: | Addiction Vol. 117; no. 2; pp. 411 - 425 |
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| Autores principales: | , , , , , , , , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Feb2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=154579710&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 154579710 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09652140 AIO jtl: Addiction issn: 09652140 maglogo: Y pubinfo: dt: Feb2022 vid: 117 iid: 2 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 154579710 151610268 154579710 154579710 10.1111/add.15630 154579710 ppf: 411 ppct: 14 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: An intensive model of care for hepatitis C virus screening and treatment with direct‐acting antivirals in people who inject drugs in Nairobi, Kenya: a model‐based cost‐effectiveness analysis. aug: au: Mafirakureva, Nyashadzaishe Stone, Jack Fraser, Hannah Nzomukunda, Yvonne Maina, Aron Thiong'o, Angela W. Kizito, Kibango Walter Mucara, Esther W. K. González Diaz, C. Inés Musyoki, Helgar Mundia, Bernard Cherutich, Peter Nyakowa, Mercy Lizcano, John Chhun, Nok Kurth, Ann Akiyama, Matthew J. Waruiru, Wanjiru Bhattacharjee, Parinita Cleland, Charles affil: Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK sug: subj: Cost Benefit Analysis Hepatitis C Diagnosis Health Screening Hepatitis C Drug Therapy Antiviral Agents Therapeutic Use Persons Who Use Intravenous Drugs Kenya Harm Reduction Human Kenya Pilot Studies Patient Care Models, Theoretical Hepatitis C Transmission HIV Infections Transmission Hepatitis C Prevention and Control Attitude of Health Personnel Sensitivity and Specificity Health Care Costs Descriptive Statistics Antiviral Agents Economics Hepatitis C, Chronic Diagnosis Hepatitis C, Chronic Drug Therapy Low and Middle Income Countries ab: Background and aims: Hepatitis C virus (HCV) treatment is essential for eliminating HCV in people who inject drugs (PWID), but has limited coverage in resource‐limited settings. We measured the cost‐effectiveness of a pilot HCV screening and treatment intervention using directly observed therapy among PWID attending harm reduction services in Nairobi, Kenya. Design We utilized an existing model of HIV and HCV transmission among current and former PWID in Nairobi to estimate the cost‐effectiveness of screening and treatment for HCV, including prevention benefits versus no screening and treatment. The cure rate of treatment and costs for screening and treatment were estimated from intervention data, while other model parameters were derived from literature. Cost‐effectiveness was evaluated over a life‐time horizon from the health‐care provider's perspective. One‐way and probabilistic sensitivity analyses were performed. Setting Nairobi, Kenya. Population PWID. Measurements Treatment costs, incremental cost‐effectiveness ratio (cost per disability‐adjusted life year averted). Findings The cost per disability‐adjusted life‐year averted for the intervention was $975, with 92.1% of the probabilistic sensitivity analyses simulations falling below the per capita gross domestic product for Kenya ($1509; commonly used as a suitable threshold for determining whether an intervention is cost‐effective). However, the intervention was not cost‐effective at the opportunity cost‐based cost‐effectiveness threshold of $647 per disability‐adjusted life‐year averted. Sensitivity analyses showed that the intervention could provide more value for money by including modelled estimates for HCV disease care costs, assuming lower drug prices ($75 instead of $728 per course) and excluding directly‐observed therapy costs. Conclusions: The current strategy of screening and treatment for hepatitis C virus (HCV) among people who inject drugs in Nairobi is likely to be highly cost‐effective with currently available cheaper drug prices, if directly‐observed therapy is not used and HCV disease care costs are accounted for. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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