|Equation||(# individuals treated) x (% individuals treated solely because of the program) x (# QALY increase) x ($ QALY)|
|Explanation||This metric estimates the impact of hepatitis B or C treatment leading to improved health, estimated in terms of quality-adjusted life years (QALY).
Number of individuals treated: Reported by program.
Percentage of participants who are treated solely because of the program: [16%]. Toy (2017) reports that about 35% of individuals with hepatitis B are diagnosed in the U.S. and 45% of these diagnosed individuals are treated, resulting in a 16% treatment rate.
Hepatitis B – QALY increase: . This is based on an average over several different types of treatments, populations, and studies (Dakin, Bentley & Dusheiko, 2010; Kanwal et al., 2005; Veenstra et al., 2008).
Hepatitis C – QALY increase: [1.9]. This is based on findings from Siebert & Sroczynski (2005) and Deniz et al. (2011).
$ value per QALY: [$50,000]
Benefits are then discounted to present value based on the average age of participation to life expectancy.
|References||Dakin, H., Bentley, A. & Dusheiko, G. (2010). Cost-utility analysis of tenofovir disoproxil fumarate in the treatment of chronic hepatitis B. Value in Health: The Journal of the International Society for Pharmacoeconomics and Outcomes Research, 13(8), 922–933.
Deniz, B., Brogan, A. J., Miller, J. D., Talbird, S. E, Thompson, J. R., 2RTI Health Solutions & 3RTI Health Solutions. (2011). Cost-effectiveness of telaprevir combination treatment compared to pegylated- interferon + ribavirin alone in the management of chronic hepatitis C in patients who failed a prior pegylated-interferon + ribavirin treatment. Paper presented at the 62nd Annual Meeting of the American Association for the Study of Liver Diseases, San Francisco, CA.
Kanwal, F., Gralnek, I. M., Martin, P., Dulai, G. S., Farid, M., & Spiegel, B. M. R. (2005). Treatment alternatives for chronic hepatitis B virus infection: a cost-effectiveness analysis. Annals of Internal Medicine, 142(10), 821–831.
Siebert, U., & Sroczynski, G., German Hepatitis C Model GEHMO Group, & HTA Expert Panel on Hepatitis C. (2005). Effectiveness and cost-effectiveness of initial combination therapy with interferon/peginterferon plus ribavirin in patients with chronic hepatitis C in Germany: a health technology assessment commissioned by the German Federal Ministry of Health and Social Security. International Journal of Technology Assessment in Health Care, 21(1), 55–65.
Toy, M. (2017). Population health impact and cost-effectiveness of chronic hepatitis B diagnosis, care, and treatment in the United States. Appendix A in G. J. Buckley, & B. L. Strom (Eds.) A national strategy for the elimination of Hepatitis B and C, Phase two report. Washington, D.C.: National Academies Press. Retrieved from: https://www.nap.edu/read/24731/chapter/10#204
Veenstra, D. L., Sullivan, S. D., Lai, M., Lee, C., Tsai, C. & Patel, K. K. (2008). HBeAg-negative chronic hepatitis B: Cost-effectiveness of peginterferon alfa-2a compared to lamivudine in Taiwan. Value in Health: The Journal of the International Society for Pharmacoeconomics and Outcomes Research, 11(2), 131–138.