Cost-effectiveness analysis of an outreach model of Hepatitis C Virus (HCV) assessment to facilitate HCV treatment in primary care

David Brain; Jonathan Mitchell; James O'Beirne

doi:10.1371/journal.pone.0234577

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Cost-effectiveness analysis of an outreach model of Hepatitis C Virus (HCV) assessment to facilitate HCV treatment in primary care

Journal article

Open access

Peer reviewed

Cost-effectiveness analysis of an outreach model of Hepatitis C Virus (HCV) assessment to facilitate HCV treatment in primary care

David Brain, Jonathan Mitchell and James O'Beirne

PLoS One, Vol.15(6), pp.1-13

2020

DOI: https://doi.org/10.1371/journal.pone.0234577

PMCID: PMC7299404

PMID: 32555696

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Abstract

The effects of hepatitis C virus (HCV), such as morbidity and mortality associated with cir-rhosis and liver cancer, is a major public health issue in Australia. Highly effective treatment has recently been made available to all Australians living with HCV. A decision-analytic model was developed to evaluate the cost-effectiveness of the hepatology partnership, compared to usual care. A Markov model was chosen, as it is state-based and able to include recursive events, which accurately reflects the natural history of the chronic and repetitive nature of HCV. Cost-effectiveness of the new model of care is indicated by the incremental cost-effectiveness ratio (ICER), where the mean change to costs associated with the new model of care is divided by the mean change in quality adjusted life-years (QALYs). Ten thousand iterations of the model were run, with the majority (73%) of ICERs representing cost-savings. In comparison to usual care, the intervention improves health outcomes (22.38 QALYs gained) and reduces costs by $42,122 per patient. When compared to usual care, a partnership approach to management of HCV is cost-effective and good value for money, even when key model parameters are changed in scenario analyses. Reduction in costs is driven by improved efficiency of the new model of care, where more patients are treated in a timely manner, away from the expensive tertiary setting. From an economic perspective, a reduction in hospital-based care is a positive outcome and represents a good investment for decision-makers who wish to maximise health gain per dollar spent.

Details

Title: Cost-effectiveness analysis of an outreach model of Hepatitis C Virus (HCV) assessment to facilitate HCV treatment in primary care
Authors: David Brain (Author) - Queensland University of Technology
Jonathan Mitchell (Author) - University of the Sunshine Coast, Queensland
James O'Beirne (Author) - University of the Sunshine Coast
Publication details: PLoS One, Vol.15(6), pp.1-13
Publisher: Public Library of Science
Date published: 2020
DOI: 10.1371/journal.pone.0234577
ISSN: 1932-6203
PMID: 32555696; PMC7299404
Copyright note: Copyright: © 2020 Brain et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Organisation Unit: University of the Sunshine Coast, Queensland; School of Health and Behavioural Sciences - Legacy
Language: English
Record Identifier: 99467307402621
Output Type: Journal article

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Collaboration types: Domestic collaboration
Web Of Science research areas: Gastroenterology & Hepatology

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