Imperial College London
Alternate

ProfessorMarkThursz

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Professor of Hepatology. Head of Department
 
 
 
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Contact

 

+44 (0)20 3312 1903m.thursz

 
 
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Assistant

 

Ms Dawn Campbell +44 (0)20 3312 6454

 
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Location

 

Norfolk PlaceSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Schmit:2023:10.7189/jogh.13.04004,
author = {Schmit, N and Nayagam, A and Lemoine, M and Ndow, G and Shimakawa, Y and Thursz, M and Hallett, T},
doi = {10.7189/jogh.13.04004},
journal = {Journal of Global Health},
pages = {1--11},
title = {Cost-effectiveness of different monitoring strategies in a screening and treatment programme for hepatitis B in The Gambia},
url = {http://dx.doi.org/10.7189/jogh.13.04004},
volume = {13},
year = {2023}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background:Clinical management of chronic hepatitis B virus (HBV) infection is complex and access to antiviral treatment remains limited in sub-Saharan Africa. International guidelines recommend monitoring at least annually for disease progression among HBV-infected people not meeting treatment criteria at initial diagnosis. This study aimed to assess the impact and cost-effectiveness of alternative strategies for monitoring.Methods:We used a mathematical model of HBV transmission and natural history, calibrated to all available West African data, to project the population-level health impact, costs and cost-effectiveness of different monitoring strategies for HBV-infected individuals not initially eligible for antiviral treatment. We assumed that these patients were found in the year 2020 in a hypothetical community-based screening programme in The Gambia. Monitoring frequencies were varied between every 5 and every 1 year and targeted different age groups.Results:The currently recommended annual monitoring frequency was likely to be not cost-effective in comparison with other strategies in this setting. 5-yearly monitoring in 15-45-year olds, at US$338 per disability-adjusted life year averted, had the highest probability of being the most effective cost-effective monitoring strategy.Conclusions:Monitoring less frequently than once a year is a cost-effective strategy in a community-based HBV screening and treatment programme in The Gambia, with the optimal strategy depending on the cost-effectiveness threshold. Efficiencies may be gained by prioritising the 15-45-year age group for more intensive monitoring.
AU  - Schmit,N
AU  - Nayagam,A
AU  - Lemoine,M
AU  - Ndow,G
AU  - Shimakawa,Y
AU  - Thursz,M
AU  - Hallett,T
DO  - 10.7189/jogh.13.04004
EP  - 11
PY  - 2023///
SN  - 2047-2978
SP  - 1
TI  - Cost-effectiveness of different monitoring strategies in a screening and treatment programme for hepatitis B in The Gambia
T2  - Journal of Global Health
UR  - http://dx.doi.org/10.7189/jogh.13.04004
UR  - https://jogh.org/wp-content/uploads/2023/01/jogh-13-04004.pdf
UR  - http://hdl.handle.net/10044/1/102023
VL  - 13
ER  -
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