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DC Field | Value | Language |
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dc.contributor.author | Tsochatzis, EA | - |
dc.contributor.author | Crossan, C | - |
dc.contributor.author | Longworth, L | - |
dc.contributor.author | Gurusamy, K | - |
dc.contributor.author | Rodriguez-Peralvarez, M | - |
dc.contributor.author | Mantzoukis, K | - |
dc.contributor.author | O'Brien, J | - |
dc.contributor.author | Thalassinos, E | - |
dc.contributor.author | Papastergiou, V | - |
dc.contributor.author | Noel-Storr, A | - |
dc.contributor.author | Davidson, B | - |
dc.contributor.author | Burroughs, AK | - |
dc.date.accessioned | 2015-01-30T15:59:32Z | - |
dc.date.available | 2014 | - |
dc.date.available | 2015-01-30T15:59:32Z | - |
dc.date.issued | 2014 | - |
dc.identifier.citation | Hepatology, 60:3, pp. 832 - 843, 2014 | en_US |
dc.identifier.issn | 0270-9139 | - |
dc.identifier.uri | http://onlinelibrary.wiley.com/doi/10.1002/hep.27296/abstract | - |
dc.identifier.uri | http://bura.brunel.ac.uk/handle/2438/10039 | - |
dc.description.abstract | The cost-effectiveness of noninvasive tests (NITs) as alternatives to liver biopsy is unknown. We compared the cost-effectiveness of using NITs to inform treatment decisions in adult patients with chronic hepatitis C (CHC). We conducted a systematic review and meta-analysis to calculate the diagnostic accuracy of various NITs using a bivariate random-effects model. We constructed a probabilistic decision analytical model to estimate health care costs and outcomes (quality-adjusted life-years; QALYs) using data from the meta-analysis, literature, and national UK data. We compared the cost-effectiveness of four treatment strategies: testing with NITs and treating patients with fibrosis stage ≥F2; testing with liver biopsy and treating patients with ≥F2; treat none; and treat all irrespective of fibrosis. We compared all NITs and tested the cost-effectiveness using current triple therapy with boceprevir or telaprevir, but also modeled new, more-potent antivirals. Treating all patients without any previous NIT was the most effective strategy and had an incremental cost-effectiveness ratio (ICER) of £9,204 per additional QALY gained. The exploratory analysis of currently licensed sofosbuvir treatment regimens found that treat all was cost-effective, compared to using an NIT to decide on treatment, with an ICER of £16,028 per QALY gained. The exploratory analysis to assess the possible effect on results of new treatments, found that if SVR rates increased to >90% for genotypes 1-4, the incremental treatment cost threshold for the "treat all" strategy to remain the most cost-effective strategy would be £37,500. Above this threshold, the most cost-effective option would be noninvasive testing with magnetic resonance elastography (ICER=£9,189). Conclusions: Treating all adult patients with CHC, irrespective of fibrosis stage, is the most cost-effective strategy with currently available drugs in developed countries. © 2014 The Authors. | en_US |
dc.format.extent | 832 - 843 | - |
dc.format.extent | 832 - 843 | - |
dc.format.extent | 832 - 843 | - |
dc.format.extent | 832 - 843 | - |
dc.language | eng | - |
dc.language.iso | en | en_US |
dc.publisher | John Wiley and Sons Inc. | en_US |
dc.subject | Cost-effectiveness | en_US |
dc.subject | Noninvasive tests (NITs) | en_US |
dc.title | Cost-effectiveness of noninvasive liver fibrosis tests for treatment decisions in patients with chronic hepatitis C | en_US |
dc.type | Article | en_US |
dc.identifier.doi | http://dx.doi.org/10.1002/hep.27296 | - |
dc.relation.isPartOf | Hepatology | - |
dc.relation.isPartOf | Hepatology | - |
dc.relation.isPartOf | Hepatology | - |
dc.relation.isPartOf | Hepatology | - |
pubs.issue | 3 | - |
pubs.issue | 3 | - |
pubs.issue | 3 | - |
pubs.issue | 3 | - |
pubs.volume | 60 | - |
pubs.volume | 60 | - |
pubs.volume | 60 | - |
pubs.volume | 60 | - |
pubs.organisational-data | /Brunel | - |
pubs.organisational-data | /Brunel/Brunel Staff by College/Department/Division | - |
pubs.organisational-data | /Brunel/Brunel Staff by College/Department/Division/College of Health and Life Sciences | - |
pubs.organisational-data | /Brunel/Brunel Staff by College/Department/Division/College of Health and Life Sciences/Dept of Life Sciences | - |
pubs.organisational-data | /Brunel/Brunel Staff by College/Department/Division/College of Health and Life Sciences/Dept of Life Sciences/Biological Sciences | - |
pubs.organisational-data | /Brunel/Brunel Staff by Institute/Theme | - |
pubs.organisational-data | /Brunel/Brunel Staff by Institute/Theme/Institute of Environmental, Health and Societies | - |
pubs.organisational-data | /Brunel/Brunel Staff by Institute/Theme/Institute of Environmental, Health and Societies/Health Economics | - |
pubs.organisational-data | /Brunel/Specialist Centres | - |
pubs.organisational-data | /Brunel/Specialist Centres/HERG | - |
Appears in Collections: | Health Economics Research Group (HERG) |
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Fulltext.pdf | 490.21 kB | Adobe PDF | View/Open |
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