دورية أكاديمية
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.
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. |
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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).) |
References: | BMJ. 2018 Apr 16;361:k1679. (PMID: 29661805) Sci Rep. 2022 Nov 10;12(1):19257. (PMID: 36357472) Epidemiol Infect. 2018 Jun;146(8):1026-1035. (PMID: 29661260) Can J Gastroenterol Hepatol. 2020 Feb 17;2020:5258289. (PMID: 32211349) J Antimicrob Chemother. 2019 Nov 1;74(Suppl 5):v5-v16. (PMID: 31782503) BMJ Open. 2019 May 1;9(4):e024085. (PMID: 31048425) West J Emerg Med. 2018 Nov;19(6):1057-1064. (PMID: 30429942) BMJ Open. 2019 Nov 11;9(11):e027491. (PMID: 31719068) Stat Methods Med Res. 2009 Aug;18(4):381-95. (PMID: 19036912) J Viral Hepat. 2022 Jul;29(7):559-568. (PMID: 35357750) J Emerg Med. 2021 Mar;60(3):299-309. (PMID: 33213988) Infez Med. 2019 Mar 1;27(1):32-39. (PMID: 30882376) Liver Int. 2019 Apr;39(4):667-675. (PMID: 30525269) Clin Exp Hepatol. 2019 Nov;5(4):294-300. (PMID: 31893241) Liver Int. 2011 Sep;31(8):1179-90. (PMID: 21745300) PLoS One. 2016 Mar 11;11(3):e0150546. (PMID: 26967517) HIV Med. 2016 Mar;17(3):222-30. (PMID: 26919291) Health Technol Assess. 2006 Aug;10(28):iii-iv, xi-xiv, 1-183. (PMID: 16904047) Med Decis Making. 2020 Jul;40(5):669-679. (PMID: 32627657) Value Health. 2020 Jan;23(1):127-137. (PMID: 31952667) J Viral Hepat. 2021 Sep;28(9):1256-1264. (PMID: 34003556) HIV Med. 2018 Feb;19 Suppl 1:52-57. (PMID: 29488696) Acad Emerg Med. 2018 Nov;25(11):1216-1226. (PMID: 29851238) Lancet Gastroenterol Hepatol. 2018 Jun;3(6):383-403. (PMID: 29599078) Ann Intern Med. 2013 Mar 5;158(5 Pt 1):329-37. (PMID: 23460056) Euro Surveill. 2019 Jul;24(27):. (PMID: 31290390) JAMA. 2012 Dec 26;308(24):2584-93. (PMID: 23268517) Value Health. 2020 Aug;23(8):1003-1011. (PMID: 32828211) Epidemiol Infect. 2019 Jan;147:e145. (PMID: 30869036) J Public Health (Oxf). 2009 Sep;31(3):374-82. (PMID: 19596666) Liver Int. 2020 Jun;40(6):1282-1291. (PMID: 32267604) Int J Drug Policy. 2019 Oct;72:84-90. (PMID: 31351752) PLoS One. 2018 Jul 25;13(7):e0198520. (PMID: 30044779) J Viral Hepat. 2020 Jan;27(1):88-91. (PMID: 31448490) Int J Technol Assess Health Care. 2009 Apr;25(2):171-80. (PMID: 19331708) Health Technol Assess. 2007 Mar;11(11):1-205, iii. (PMID: 17346498) |
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 |
تدمد: | 1478-7547 |
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DOI: | 10.1186/s12962-022-00388-7 |