在缅甸仰光,一个分散的,以社区为基础的"一站式"型肝炎检测和治疗计划的成本效益
Thin Mar Win1, Bridget Louise Draper2,3, Anna Palmer2
1Disease Elimination, Burnet Institute Yangon Myanmar.
JGH open : an open access journal of gastroenterology and hepatology
|November 30, 2023
概括
在缅甸,一个以社区为基础的型肝炎 (HCV) 检测和治疗计划证明具有成本效益. 这种去中心化的模式提供了实现消除目标的高概率,使得HCV治疗更容易获得.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 传染病控制和控制传染病
背景情况:
- 在低收入和中等收入国家 (LMICs),由于直接作用的抗病毒治疗 (DAA) 和护理点诊断,可以消除C型肝炎 (HCV).
- 然而,测试和治疗的成本仍然是广泛实施的重大障碍.
研究的目的:
- 估计缅甸一个分散的,基于社区的HCV检测和治疗计划 (CT2) 的成本和成本效益.
- 评估该模型对实现国家HCV消除目标的影响.
主要方法:
- 使用基于队列的决定性马尔科夫模型来评估成本和结果.
- 数据包括DAA的成本,调查,医疗用品,人员,设备和开支.
- 增量成本效益比率 (ICER) 是通过将CT2模型与无治疗场景进行比较来计算的.
主要成果:
- CT2计划招募了633名患者,其中488人接受治疗.
- 估计ICER为294美元 (192-340) 每个质量调整后生命年 (QALY) 获得.
- 该模型显示,与支付意愿基准相比,其具有90%的成本效益概率.
结论:
- 在缅甸,去中心化的CT2模式对HCV护理是一种具有成本效益的战略.
- 建议扩大该计划,以实现2030年国家肝炎控制计划的目标.
- 提高服务负担能力和可访问性对于成功消除HCV至关重要.
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