Cost-Effectiveness of Access Expansion to Treatment of Hepatitis C Virus Infection Through Primary Care Providers

Gastroenterology
Thilo RattayDavid W Hutton

Abstract

Chronic hepatitis C virus (HCV) infection is a major burden on individuals and health care systems. The Extension for Community Healthcare Outcomes (Project ECHO) enables primary care providers to deliver best-practice care for complex conditions to underserved populations. The US Congress passed the ECHO Act in late 2016, requiring the Department of Health and Human Services to investigate the model. We performed a cost-effectiveness analysis to assess diagnosis and treatment of HCV infection in a primary care patient panel with and without the implementation of Project ECHO. We used Markov models to simulate disease progression, quality of life, and life expectancy among individuals with HCV infection and for the general population. Data from the University of New Mexico's ECHO operation for HCV show an increase in treatment rates. Corresponding increases in survival, quality-adjusted life years (QALYs), costs, and resulting budget impact between ECHO and non-ECHO patients with HCV were then compared. Project ECHO increased costs and QALYs. The incremental cost-effectiveness ratio of ECHO was $10,351 per QALY compared with the status quo; >99.9% of iterations fell below the willingness-to-pay threshold of $100,000 per QALY. W...Continue Reading

Citations

Nov 7, 2018·Journal of Viral Hepatitis·Zobair YounossiAngelos Hatzakis
Sep 14, 2018·Journal of Pediatric Gastroenterology and Nutrition·Radha K DhimanSandeep Satsangi
Dec 19, 2018·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Jie WuLanjuan Li
Jan 3, 2020·European Journal of Gastroenterology & Hepatology·Jeyamani RamachandranAlan J Wigg
Dec 14, 2018·Current Treatment Options in Infectious Diseases·Autumn ZuckermanCody A Chastain
Mar 7, 2020·Hepatology Communications·Albert Do, Nancy S Reau
Jul 16, 2020·Open Forum Infectious Diseases·Hyun-Seok KimAaron P Thrift
Oct 20, 2020·Journal of Medical Internet Research·Centaine L SnoswellLiam J Caffery
Mar 18, 2021·Infectious Diseases·Krishna C Poudel, Kalpana Poudel-Tandukar
Jul 17, 2021·Liver International : Official Journal of the International Association for the Study of the Liver·Ignazio GrattaglianoClaudio Cricelli
Sep 11, 2021·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Brian M FungJames H Tabibian

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