Evidence map›Paper›PMID 38321475›Full record

ArticleCost effectiveness and resource allocation : C/E2024

Is it time for China to prioritize pan-genotypic regimens for treating patients with hepatitis C?

Yusi Tu, Xiangyan Tang, Dachuang Zhou, Hanqiao Shao, Leyi Liang, Wenxi Tang

Abstract read
In one paragraph

Article in Cost effectiveness and resource allocation : C/E, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Yusi Tu *Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, 211198, China.
Xiangyan Tang *Center for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, 211198, China.
Dachuang ZhouCenter for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, 211198, China.
Hanqiao ShaoCenter for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, 211198, China.
Leyi LiangCenter for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, 211198, China.
Wenxi TangCenter for Pharmacoeconomics and Outcomes Research, China Pharmaceutical University, Nanjing, 211198, China. tokammy@cpu.edu.cn.

Funding

National Innovation and Entrepreneurship Training Program for Undergraduate No.202310316065Y
6 · The paper itself

Abstract

introductionThe treatment of hepatitis C has entered the pan-genotypic era, but the effectiveness is not good for the genotype 3b patients who have a large proportion in China. The guidelines for hepatitis C recommend the use of gene-specific regimens when the regional 3b prevalence rate greater than 5%. This study is to explore rationality of this proportion and the cost-effectiveness to implement pan-genotypic regimens in China.

methodsA decision Markov model was developed from the health system perspective to evaluate the effectiveness and cost-effectiveness between pan-genotypic and gene-specific treatment regimens for hepatitis C patients. Additionally, we set a regional genotype 3b patient proportion of 0-100% to explore at which proportion it is necessary to perform genotype identification and typing therapy on patients. Model parameters were derived from published literature and public databases. Effectiveness was measured by cured patient numbers, newly diagnosed cases of decompensated cirrhosis, hepatocellular carcinoma, need for liver transplantation, and quality-adjusted life years (QALYs). Cost-effectiveness outcomes included costs and the incremental cost-effectiveness ratio (ICER). The 1-3 times 2022 Chinese per capita gross domestic product was used as the willingness-to-pay threshold. One-way and probabilistic sensitivity analyses were performed to assess the uncertainty of the model parameters.

resultsCompared with gene-specific regimens, pan-genotypic regimens resulted in an additional 0.13 QALYs and an incremental cost of $165, the ICER was $1,268/QALY. From the view of efficacy, the pan-genotypic regimens cured 5,868 more people per 100,000 patients than gene-specific regimens, avoiding 86.5% of DC cases, 64.6% of HCC cases, and 78.2% of liver transplant needs. Identifying 3b patients before treatment was definitely cost-effectiveness when their prevalence was 12% or higher. The results remained robust in sensitivity analyses.

conclusionsIn China, the prioritized recommendation of pan-genotypic therapeutics proves to be both cost-effective and efficacious. But, in regions where the prevalence of genotype 3b exceeds 12%, it is necessary to identify them to provision of more suitable therapies.

Indexed as

Cost-effectiveness analysisDecision-analytic Markov modelHepatitis CPan-genotypic regimens

Identifiers

PMID38321475
PMCPMC10848349

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.