دورية أكاديمية
أعرض في EDS

Universal testing for hepatitis B and hepatitis C in the emergency department: a cost-effectiveness and budget impact analysis of two urban hospitals in the United Kingdom.

التفاصيل البيبلوغرافية
العنوان: Universal testing for hepatitis B and hepatitis C in the emergency department: a cost-effectiveness and budget impact analysis of two urban hospitals in the United Kingdom.
المؤلفون: Williams J; Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock place, London, WC1H 9SH, UK. Jack.Williams@lshtm.ac.uk.; The National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at University College, London, UK. Jack.Williams@lshtm.ac.uk., Vickerman P; Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK.; The NIHR HPRU in Behavioural Science and Evaluation at the University of Bristol, Bristol, UK., Smout E; UK Field Epidemiology Training Programme, UK Health Security Agency, Leeds, UK., Page EE; Virology, Microbiology Department, Leeds Teaching Hospitals Trust, Leeds, UK., Phyu K; Virology, Microbiology Department, Leeds Teaching Hospitals Trust, Leeds, UK., Aldersley M; Virology, Microbiology Department, Leeds Teaching Hospitals Trust, Leeds, UK., Nebbia G; Department of Infection, Guy's and St Thomas' NHS Foundation Trust, London, UK., Douthwaite S; Department of Infection, Guy's and St Thomas' NHS Foundation Trust, London, UK., Hunter L; Emergency Department, Guy's and St Thomas' NHS Foundation Trust, London, UK., Ruf M; Public Health-Medical Department, Gilead Sciences Ltd UK and Ireland, London, UK., Miners A; Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock place, London, WC1H 9SH, UK.; The National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at University College, London, UK.
المصدر: Cost effectiveness and resource allocation : C/E [Cost Eff Resour Alloc] 2022 Nov 14; Vol. 20 (1), pp. 60. Date of Electronic Publication: 2022 Nov 14.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101170476 Publication Model: Electronic Cited Medium: Print ISSN: 1478-7547 (Print) Linking ISSN: 14787547 NLM ISO Abbreviation: Cost Eff Resour Alloc Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2003]-
مستخلص: Background: Numerous studies have shown the effectiveness of testing for hepatitis B (HBV) and hepatitis C (HCV) in emergency departments (ED), due to the elevated prevalence amongst attendees. The aim of this study was to conduct a cost-effectiveness analysis of universal opt-out HBV and HCV testing in EDs based on 2 long-term studies of the real-world effectiveness of testing in 2 large ED's in the UK.
Methods: A Markov model was used to evaluate ED-based HBV and HCV testing versus no ED testing, in addition to current testing practice. The two EDs had a HBV HBsAg prevalence of 0.5-0.9% and an HCV RNA prevalence of 0.9-1.0%. The analysis was performed from a UK health service perspective, over a lifetime time horizon. Costs are reported in British pounds (GBP), and outcomes as quality adjusted life years (QALYs), with both discounted at 3.5% per year. Incremental cost-effectiveness ratios (ICER) are calculated as costs per QALY gained. A willingness-to-pay threshold of £20,000/QALY was used. The cost-effectiveness was estimated for both infections, in both ED's.
Results: HBV and HCV testing were highly cost-effective in both settings, with ICERs ranging from £7,177 to £12,387 per QALY gained. In probabilistic analyses, HBV testing was 89-94% likely to be cost-effective at the threshold, while HCV testing was 94-100% likely to be cost-effective, across both settings. In deterministic sensitivity analyses, testing remained cost-effective in both locations at ≥ 0.25% HBsAg prevalence, and ≥ 0.49% HCV RNA prevalence. This is much lower than the prevalence observed in the two EDs included in this study.
Conclusions: HBV and HCV testing in urban EDs is highly cost-effective in the UK, and can be cost-effective at relatively low prevalence. These results should be reflected in UK and European hepatitis testing guidelines.
(© 2022. The Author(s).)
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فهرسة مساهمة: Keywords: Budget impact; Economic evaluation; Emergency department; Hepatitis B; Hepatitis C
تواريخ الأحداث: Date Created: 20221115 Latest Revision: 20221118
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC9664679
DOI: 10.1186/s12962-022-00388-7
PMID: 36376920
قاعدة البيانات: MEDLINE
الوصف
تدمد:1478-7547
DOI:10.1186/s12962-022-00388-7