Antiviral therapy for hepatitis B-related liver cancer prevention is more cost-effective than cancer screening

[Guest guest]

http://www.ncbi.nlm.nih.gov/pubmed/19303657

J Hepatol. 2009 Feb 15. [Epub ahead of print]

Antiviral therapy for hepatitis B-related liver cancer prevention is more

cost-effective than cancer screening.

Robotin MC, Kansil M, K, J, Tipper S, Dore GJ, Levy M, Penman AG.

The Cancer Council NSW, Research Strategy and Scientific Development Unit, 153

Dowling St, Woolloomooloo, NSW 2011, Sydney, Australia; PO Box 572, Kings Cross

NSW 1340 Australia; University of Sydney, School of Public Health, Ford

Building A27, University of Sydney, NSW 2006, Australia.

BACKGROUND/AIMS: In Australia, Asian-born populations are 6-12 times more likely

to develop hepatocellular cancer (HCC) than Australian-born individuals. We

therefore, modelled the consequences of different management strategies for

chronic hepatitis B (CHB) in Asian-born adults aged 35 years. METHODS: A Markov

model compared (1) enhanced surveillance for HCC alone (HCC surveillance), or

(2) enhanced HCC surveillance coupled with CHB treatment (HCC prevention) to the

current practice, of low CHB treatment uptake. Patients were stratified and

managed according to risk categories, based upon hepatitis B virus (HBV) viral

load and alanine aminotransferase (ALT) levels. We measured costs, health

outcomes [cases of HCC and deaths averted, quality-adjusted life-years (QALYs)

gained] and incremental cost-effectiveness ratios (ICERs). RESULTS: HCC

surveillance would cost on average AU$8479 per person, compared to AU$2632 with

current clinical practice and result in a gain of 0.014 QALYs (AU$401,516/QALY

gained). A HCC prevention strategy would cost on average AU$14,600 per person,

result in 0.923 QALYs gained (AU$12,956/QALY gained), reduce cases of cirrhosis

by 52%, HCC diagnoses by 47% and CHB-related deaths by 56%, compared to current

practice. CONCLUSIONS: HCC prevention appears to be a cost-effective public

health strategy in at-risk populations in Australia and is preferable to HCC

surveillance as a cancer control strategy.

PMID: 19303657 [PubMed - as supplied by publisher]

[Guest guest]

http://www.ncbi.nlm.nih.gov/pubmed/19303657

J Hepatol. 2009 Feb 15. [Epub ahead of print]

Antiviral therapy for hepatitis B-related liver cancer prevention is more

cost-effective than cancer screening.

Robotin MC, Kansil M, K, J, Tipper S, Dore GJ, Levy M, Penman AG.

The Cancer Council NSW, Research Strategy and Scientific Development Unit, 153

Dowling St, Woolloomooloo, NSW 2011, Sydney, Australia; PO Box 572, Kings Cross

NSW 1340 Australia; University of Sydney, School of Public Health, Ford

Building A27, University of Sydney, NSW 2006, Australia.

BACKGROUND/AIMS: In Australia, Asian-born populations are 6-12 times more likely

to develop hepatocellular cancer (HCC) than Australian-born individuals. We

therefore, modelled the consequences of different management strategies for

chronic hepatitis B (CHB) in Asian-born adults aged 35 years. METHODS: A Markov

model compared (1) enhanced surveillance for HCC alone (HCC surveillance), or

(2) enhanced HCC surveillance coupled with CHB treatment (HCC prevention) to the

current practice, of low CHB treatment uptake. Patients were stratified and

managed according to risk categories, based upon hepatitis B virus (HBV) viral

load and alanine aminotransferase (ALT) levels. We measured costs, health

outcomes [cases of HCC and deaths averted, quality-adjusted life-years (QALYs)

gained] and incremental cost-effectiveness ratios (ICERs). RESULTS: HCC

surveillance would cost on average AU$8479 per person, compared to AU$2632 with

current clinical practice and result in a gain of 0.014 QALYs (AU$401,516/QALY

gained). A HCC prevention strategy would cost on average AU$14,600 per person,

result in 0.923 QALYs gained (AU$12,956/QALY gained), reduce cases of cirrhosis

by 52%, HCC diagnoses by 47% and CHB-related deaths by 56%, compared to current

practice. CONCLUSIONS: HCC prevention appears to be a cost-effective public

health strategy in at-risk populations in Australia and is preferable to HCC

surveillance as a cancer control strategy.

PMID: 19303657 [PubMed - as supplied by publisher]