弥合C型肝炎护理差距:在加拿大安大略省实现世界卫生组织目标的建模方法
Yeva Sahakyan1, Aysegul Erman1,2, William W L Wong1,2,3
1Toronto Health Economics and Technology Assessment Collaborative (THETA), University Health Network, Toronto, ON M5G 2C4, Canada.
Viruses
|August 29, 2024
概括
为了实现世界卫生组织的C型肝炎病毒 (HCV) 消除目标,扩大RNA测试和治疗是至关重要的. 双重抗体检测可能会在2035年实现死亡率目标,而不是2030年,但仍然具有成本效益.
科学领域:
- 肝病学和传染病的研究
- 公共卫生政策 公共卫生政策
- 卫生经济学 卫生经济学
背景情况:
- 世界卫生组织 (WHO) 已经制定了2030年消除C型肝炎病毒 (HCV) 的目标.
- 识别HCV护理级联中的差距对于实现这些目标至关重要.
- 本研究评估了在加拿大安大略省实现世卫组织HCV消除目标所需的服务扩展.
研究的目的:
- 确定在HCV护理级联中必要的服务扩展,以实现世卫组织在安大略省的HCV消除目标.
- 预测安大略省与HCV相关的质量调整寿命年 (QALY) 和医疗保健成本.
主要方法:
- 使用决策分析模型预测了安大略省HCV患者的QALY和医疗费用.
- RNA测试和治疗率提高到98%.
- 增加了抗体测试的使用量,以实现世卫组织2030年减少死亡率的目标.
主要成果:
- 在没有扩大规模的情况下,预计QALY和人均成本分别为9.156加元和48,996加元.
- 增加RNA测试和治疗将与肝脏相关的死亡减少了57% (至3.3/100,000).
- 将抗体检测率翻一番可以在2035年之前实现世卫组织的死亡率目标,但不能在2030年之前实现.
结论:
- 增加RNA检测和治疗,加上抗体检测率翻倍,显示出在2035年前实现世卫组织目标的潜力.
- 如果每年实施成本低于2.3M CAD/100,000人,则干预措施在获得的50,000 CAD/QALY门内具有成本效益.
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