BibTex format
@article{Nayagam:2016:10.1016/S2214-109X(16)30101-2,
author = {Nayagam, S and Conteh, L and Sicuri, E and Shimakawa, Y and Tamba, S and Suso, P and Njie, R and Njai, H and Lemoine, M and Hallett, TB and Thursz, M},
doi = {10.1016/S2214-109X(16)30101-2},
journal = {Lancet Global Health},
pages = {e568--e578},
title = {Cost-effectiveness of community-based screening and treatment for chronic hepatitis B in The Gambia: an economic modelling analysis},
url = {http://dx.doi.org/10.1016/S2214-109X(16)30101-2},
volume = {4},
year = {2016}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - Background: Despite the high burden of hepatitis B virus (HBV)infection in sub-Saharan Africa (SSA), a lack of access to widespreadscreening or treatment leads to most people remaining undiagnosed untillater stages of disease when prognosis is poor and treatment options arelimited. We evaluated the cost-effectiveness of community-based screeningand early treatment with antiviral therapy for HBV in The Gambia.Methods: An economic evaluation comparing adult community-based screeningusing a Hepatitis B surface antigen (HBsAg) rapid test and subsequent HBVantiviral therapy to a status quo scenario, where no treatment isavailable, was performed by combining a decision tree with a Markov statetransition model. This was parameterised with primary screening and costdata from the PROLIFICA study. A health provider perspective was takenand costs and health outcomes were discounted at 3% per annum.Findings: In The Gambia, where the HBsAg prevalence is 8.8% among thoseaged over 30 years old, adult screening and treatment for HBV, has anIncremental Cost-Effectiveness Ratio (ICER) of $540 per DisabilityAdjusted Life Year (DALY) averted, $645 per Life Year (LY) saved and $511per Quality Adjusted Life Year (QALY) gained, compared to status quo.These ICERs are in line with willingness-to-pay levels of one times thecountry's Gross Domestic Product (GDP) per capita ($487) per DALYaverted, whilst remaining robust, over a wide range of epidemiologicaland cost parameters.Interpretation: Adult community-based screening and treatment for HBV inthe Gambia is likely to be a cost-effective intervention with an ICERthat is comparable with those of HIV screening and treatmentinterventions in SSA. Even higher cost-effectiveness, may be achievablewith targeted facility-based screening, price reductions of drug and diagnostics and integration of HBV screening with other public healthinterventions.
AU - Nayagam,S
AU - Conteh,L
AU - Sicuri,E
AU - Shimakawa,Y
AU - Tamba,S
AU - Suso,P
AU - Njie,R
AU - Njai,H
AU - Lemoine,M
AU - Hallett,TB
AU - Thursz,M
DO - 10.1016/S2214-109X(16)30101-2
EP - 578
PY - 2016///
SN - 2214-109X
SP - 568
TI - Cost-effectiveness of community-based screening and treatment for chronic hepatitis B in The Gambia: an economic modelling analysis
T2 - Lancet Global Health
UR - http://dx.doi.org/10.1016/S2214-109X(16)30101-2
UR - https://www.sciencedirect.com/science/article/pii/S2214109X16301012?via%3Dihub
VL - 4
ER -