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Cost-effectiveness of treating hepatitis C in Seychelles.

Authors
  • Adeline, Naomi Joan Faray1
  • Geue, Claudia2
  • Hermami, Mohsen Rezaei3
  • 1 Communicable Disease Control Unit, Ministry of Health Seychelles, Victoria, Seychelles. , (Seychelles)
  • 2 Health Economics and Health Technology Assessment, University of Glasgow, United Kingdom. , (United Kingdom)
  • 3 PenTAG Health Technology Assessment, University of Exeter, United Kingdom. , (United Kingdom)
Type
Published Article
Journal
Pan African Medical Journal
Publisher
Pan African Medical Journal
Publication Date
Jan 01, 2019
Volume
33
Pages
26–26
Identifiers
DOI: 10.11604/pamj.2019.33.26.17742
PMID: 31384341
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

approximately eighty million people around the world are living with hepatitis C, and 700,000 people die every year, due to hepatitis C related complications. In Seychelles, a total of 777 cases of hepatitis C were reported from 2002 to 2016, but up to mid of 2016, the cases were not being treated. Treatment with Harvoni, a combination of sofosbuvir and ledipasvir (SOF/LDV), is now being offered on the condition that the patient does not, or has stopped, injecting drugs. This paper is the first to establish the cost effectiveness of treating all cases of hepatitis C in Seychelles with Harvoni, as compared to no treatment. data extracted from literature was used to populate an economic model to calculate cost-effectiveness from Seychelles' government perspective. The model structure was also informed by the systematic review and an accompanying grading of economic models using the Consolidated Health Economic Evaluation Reporting Standard (CHEERS) checklist. A Markov model was developed, employing a lifetime horizon and costs and benefits were analysed from a payer's perspective and combined into incremental cost effectiveness ratios (ICERs). the direct-acting antiviral (DAA), Harvoni, was found to be cost-saving in Seychelles hepatitis C virus (HCV) cohort, as compared to no treatment, with an ICER of € 753.65/QALY. The treatment was also cost-saving when stratified by gender, with the ICER of male and female being € 783.74/QALY and € 635.20/QALY, respectively. Moreover, the results obtained from acceptability curves showed that treating patients with Harvoni is the most cost-effective option, even for low thresholds. treating hepatitis C cases in Seychelles is cost-saving. It is worth developing a treatment programme to include all cases of hepatitis C, regardless of status of drug injection.

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