Early Treatment of Hepatitis C Virus Improves Health Outcomes and Yields Cost-Savings: A Modeling Study in Argentina

Autores
Elgart, Jorge Federico; Glancszpigel, Mariana; Albaytero, Natalia; Kanevsky, Diego; Rodriguez, Maria Florencia; Mendizabal, Manuel; Sánchez González, Yuri
Año de publicación
2022
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
OBJECTIVE: Most untreated hepatitis C virus (HCV) patients develop chronic infection and severe complications, including death. Direct-acting antivirals in early stages of liver fibrosis reduce complications and healthcare costs. However, therapy is often delayed, and patients in early stages have limited access to effective treatments. We assessed the clinical and economic effect of treating chronic HCV at early versus late stages of disease in Argentina. METHODS: A Markov model of the natural HCV history was used to forecast lifetime liver-related and economic outcomes from social security sector perspective. Healthcare use and transition probabilities were drawn from literature. Demographic characteristics of the patients and treatment attributes were based on data from registrational trials of glecaprevir/pibrentasvir. RESULTS: Lower rates of all hepatic complications and liver-related mortality were predicted when treatment was initiated in mild versus advanced disease. Sustained virologic response rates were similar among all stages. Higher quality-adjusted life years (QALYs) were predicted when treatment was initiated in mild (F0-F1) versus moderate (F2-F3) or advanced (F4) liver disease (11.5, 9.9, and 7.5 QALYs, respectively). Delaying treatment increased long-term total lifetime costs (F4: AR$ 1 437 816; F2-F3: AR$ 967 673; F0-F1: AR$ 954 018; 37.10 AR$=1 USD, Nov 2018 exchange rate) and provided fewer QALYs. CONCLUSIONS: Our study show early treatment was a dominant strategy compared with treatment in advanced stages of liver disease. These results may help health policy makers take actions to reduce health and economic burden of HCV in Argentina.
Fil: Elgart, Jorge Federico. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Endocrinología Experimental y Aplicada. Universidad Nacional de La Plata. Facultad de Ciencias Médicas. Centro de Endocrinología Experimental y Aplicada; Argentina
Fil: Glancszpigel, Mariana. 3Eff; Argentina
Fil: Albaytero, Natalia. 3eff; Argentina
Fil: Kanevsky, Diego. Abbvie Argentina; Argentina
Fil: Rodriguez, Maria Florencia. Abbvie Argentina; Argentina
Fil: Mendizabal, Manuel. Universidad Austral. Hospital Universitario Austral; Argentina
Fil: Sánchez González, Yuri. AbbVie Inc.; Estados Unidos
Materia
HEPATITIS C VIRUS
COST-EFFECTIVENESS
DIRECT-ACTING ANTIVIRAL
PAN-GENOTYPE
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/232136
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/232136
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Early Treatment of Hepatitis C Virus Improves Health Outcomes and Yields Cost-Savings: A Modeling Study in ArgentinaElgart, Jorge FedericoGlancszpigel, MarianaAlbaytero, NataliaKanevsky, DiegoRodriguez, Maria FlorenciaMendizabal, ManuelSánchez González, YuriHEPATITIS C VIRUSCOST-EFFECTIVENESSDIRECT-ACTING ANTIVIRALPAN-GENOTYPEhttps://purl.org/becyt/ford/3.5https://purl.org/becyt/ford/3OBJECTIVE: Most untreated hepatitis C virus (HCV) patients develop chronic infection and severe complications, including death. Direct-acting antivirals in early stages of liver fibrosis reduce complications and healthcare costs. However, therapy is often delayed, and patients in early stages have limited access to effective treatments. We assessed the clinical and economic effect of treating chronic HCV at early versus late stages of disease in Argentina. METHODS: A Markov model of the natural HCV history was used to forecast lifetime liver-related and economic outcomes from social security sector perspective. Healthcare use and transition probabilities were drawn from literature. Demographic characteristics of the patients and treatment attributes were based on data from registrational trials of glecaprevir/pibrentasvir. RESULTS: Lower rates of all hepatic complications and liver-related mortality were predicted when treatment was initiated in mild versus advanced disease. Sustained virologic response rates were similar among all stages. Higher quality-adjusted life years (QALYs) were predicted when treatment was initiated in mild (F0-F1) versus moderate (F2-F3) or advanced (F4) liver disease (11.5, 9.9, and 7.5 QALYs, respectively). Delaying treatment increased long-term total lifetime costs (F4: AR$ 1 437 816; F2-F3: AR$ 967 673; F0-F1: AR$ 954 018; 37.10 AR$=1 USD, Nov 2018 exchange rate) and provided fewer QALYs. CONCLUSIONS: Our study show early treatment was a dominant strategy compared with treatment in advanced stages of liver disease. These results may help health policy makers take actions to reduce health and economic burden of HCV in Argentina.Fil: Elgart, Jorge Federico. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Endocrinología Experimental y Aplicada. Universidad Nacional de La Plata. Facultad de Ciencias Médicas. Centro de Endocrinología Experimental y Aplicada; ArgentinaFil: Glancszpigel, Mariana. 3Eff; ArgentinaFil: Albaytero, Natalia. 3eff; ArgentinaFil: Kanevsky, Diego. Abbvie Argentina; ArgentinaFil: Rodriguez, Maria Florencia. Abbvie Argentina; ArgentinaFil: Mendizabal, Manuel. Universidad Austral. Hospital Universitario Austral; ArgentinaFil: Sánchez González, Yuri. AbbVie Inc.; Estados UnidosCanadian Center of Science and Education2022-10info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/232136Elgart, Jorge Federico; Glancszpigel, Mariana; Albaytero, Natalia; Kanevsky, Diego; Rodriguez, Maria Florencia; et al.; Early Treatment of Hepatitis C Virus Improves Health Outcomes and Yields Cost-Savings: A Modeling Study in Argentina; Canadian Center of Science and Education; Global Journal of Health Science; 14; 11; 10-2022; 26-361916-97361916-9744CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://ccsenet.org/journal/index.php/gjhs/article/view/0/47965info:eu-repo/semantics/altIdentifier/doi/10.5539/gjhs.v14n11p26info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-03T09:50:38Zoai:ri.conicet.gov.ar:11336/232136instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-03 09:50:38.978CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Early Treatment of Hepatitis C Virus Improves Health Outcomes and Yields Cost-Savings: A Modeling Study in Argentina
title Early Treatment of Hepatitis C Virus Improves Health Outcomes and Yields Cost-Savings: A Modeling Study in Argentina
spellingShingle Early Treatment of Hepatitis C Virus Improves Health Outcomes and Yields Cost-Savings: A Modeling Study in Argentina
Elgart, Jorge Federico
HEPATITIS C VIRUS
COST-EFFECTIVENESS
DIRECT-ACTING ANTIVIRAL
PAN-GENOTYPE
title_short Early Treatment of Hepatitis C Virus Improves Health Outcomes and Yields Cost-Savings: A Modeling Study in Argentina
title_full Early Treatment of Hepatitis C Virus Improves Health Outcomes and Yields Cost-Savings: A Modeling Study in Argentina
title_fullStr Early Treatment of Hepatitis C Virus Improves Health Outcomes and Yields Cost-Savings: A Modeling Study in Argentina
title_full_unstemmed Early Treatment of Hepatitis C Virus Improves Health Outcomes and Yields Cost-Savings: A Modeling Study in Argentina
title_sort Early Treatment of Hepatitis C Virus Improves Health Outcomes and Yields Cost-Savings: A Modeling Study in Argentina
dc.creator.none.fl_str_mv Elgart, Jorge Federico
Glancszpigel, Mariana
Albaytero, Natalia
Kanevsky, Diego
Rodriguez, Maria Florencia
Mendizabal, Manuel
Sánchez González, Yuri
author Elgart, Jorge Federico
author_facet Elgart, Jorge Federico
Glancszpigel, Mariana
Albaytero, Natalia
Kanevsky, Diego
Rodriguez, Maria Florencia
Mendizabal, Manuel
Sánchez González, Yuri
author_role author
author2 Glancszpigel, Mariana
Albaytero, Natalia
Kanevsky, Diego
Rodriguez, Maria Florencia
Mendizabal, Manuel
Sánchez González, Yuri
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv HEPATITIS C VIRUS
COST-EFFECTIVENESS
DIRECT-ACTING ANTIVIRAL
PAN-GENOTYPE
topic HEPATITIS C VIRUS
COST-EFFECTIVENESS
DIRECT-ACTING ANTIVIRAL
PAN-GENOTYPE
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.5
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv OBJECTIVE: Most untreated hepatitis C virus (HCV) patients develop chronic infection and severe complications, including death. Direct-acting antivirals in early stages of liver fibrosis reduce complications and healthcare costs. However, therapy is often delayed, and patients in early stages have limited access to effective treatments. We assessed the clinical and economic effect of treating chronic HCV at early versus late stages of disease in Argentina. METHODS: A Markov model of the natural HCV history was used to forecast lifetime liver-related and economic outcomes from social security sector perspective. Healthcare use and transition probabilities were drawn from literature. Demographic characteristics of the patients and treatment attributes were based on data from registrational trials of glecaprevir/pibrentasvir. RESULTS: Lower rates of all hepatic complications and liver-related mortality were predicted when treatment was initiated in mild versus advanced disease. Sustained virologic response rates were similar among all stages. Higher quality-adjusted life years (QALYs) were predicted when treatment was initiated in mild (F0-F1) versus moderate (F2-F3) or advanced (F4) liver disease (11.5, 9.9, and 7.5 QALYs, respectively). Delaying treatment increased long-term total lifetime costs (F4: AR$ 1 437 816; F2-F3: AR$ 967 673; F0-F1: AR$ 954 018; 37.10 AR$=1 USD, Nov 2018 exchange rate) and provided fewer QALYs. CONCLUSIONS: Our study show early treatment was a dominant strategy compared with treatment in advanced stages of liver disease. These results may help health policy makers take actions to reduce health and economic burden of HCV in Argentina.
Fil: Elgart, Jorge Federico. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Centro de Endocrinología Experimental y Aplicada. Universidad Nacional de La Plata. Facultad de Ciencias Médicas. Centro de Endocrinología Experimental y Aplicada; Argentina
Fil: Glancszpigel, Mariana. 3Eff; Argentina
Fil: Albaytero, Natalia. 3eff; Argentina
Fil: Kanevsky, Diego. Abbvie Argentina; Argentina
Fil: Rodriguez, Maria Florencia. Abbvie Argentina; Argentina
Fil: Mendizabal, Manuel. Universidad Austral. Hospital Universitario Austral; Argentina
Fil: Sánchez González, Yuri. AbbVie Inc.; Estados Unidos
description OBJECTIVE: Most untreated hepatitis C virus (HCV) patients develop chronic infection and severe complications, including death. Direct-acting antivirals in early stages of liver fibrosis reduce complications and healthcare costs. However, therapy is often delayed, and patients in early stages have limited access to effective treatments. We assessed the clinical and economic effect of treating chronic HCV at early versus late stages of disease in Argentina. METHODS: A Markov model of the natural HCV history was used to forecast lifetime liver-related and economic outcomes from social security sector perspective. Healthcare use and transition probabilities were drawn from literature. Demographic characteristics of the patients and treatment attributes were based on data from registrational trials of glecaprevir/pibrentasvir. RESULTS: Lower rates of all hepatic complications and liver-related mortality were predicted when treatment was initiated in mild versus advanced disease. Sustained virologic response rates were similar among all stages. Higher quality-adjusted life years (QALYs) were predicted when treatment was initiated in mild (F0-F1) versus moderate (F2-F3) or advanced (F4) liver disease (11.5, 9.9, and 7.5 QALYs, respectively). Delaying treatment increased long-term total lifetime costs (F4: AR$ 1 437 816; F2-F3: AR$ 967 673; F0-F1: AR$ 954 018; 37.10 AR$=1 USD, Nov 2018 exchange rate) and provided fewer QALYs. CONCLUSIONS: Our study show early treatment was a dominant strategy compared with treatment in advanced stages of liver disease. These results may help health policy makers take actions to reduce health and economic burden of HCV in Argentina.
publishDate 2022
dc.date.none.fl_str_mv 2022-10
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/232136
Elgart, Jorge Federico; Glancszpigel, Mariana; Albaytero, Natalia; Kanevsky, Diego; Rodriguez, Maria Florencia; et al.; Early Treatment of Hepatitis C Virus Improves Health Outcomes and Yields Cost-Savings: A Modeling Study in Argentina; Canadian Center of Science and Education; Global Journal of Health Science; 14; 11; 10-2022; 26-36
1916-9736
1916-9744
CONICET Digital
CONICET
url http://hdl.handle.net/11336/232136
identifier_str_mv Elgart, Jorge Federico; Glancszpigel, Mariana; Albaytero, Natalia; Kanevsky, Diego; Rodriguez, Maria Florencia; et al.; Early Treatment of Hepatitis C Virus Improves Health Outcomes and Yields Cost-Savings: A Modeling Study in Argentina; Canadian Center of Science and Education; Global Journal of Health Science; 14; 11; 10-2022; 26-36
1916-9736
1916-9744
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://ccsenet.org/journal/index.php/gjhs/article/view/0/47965
info:eu-repo/semantics/altIdentifier/doi/10.5539/gjhs.v14n11p26
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Canadian Center of Science and Education
publisher.none.fl_str_mv Canadian Center of Science and Education
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
_version_ 1842269044682522624
score 13.13397

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