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Early-stage hepatocellular carcinoma screening in patients with chronic hepatitis B in China: a cost-effectiveness analysis.
Nan, Yuemin; Garay, Osvaldo Ulises; Lu, Xianzhong; Zhang, Yue; Xie, Li; Niu, Zhongyi; Chen, Wen.
Afiliación
  • Nan Y; Department of Traditional & Western Medical Hepatology, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China.
  • Garay OU; Roche Diagnostics International, Rotkreuz, ZG, Switzerland.
  • Lu X; Roche Diagnostics (Shanghai) Co., Ltd, Shanghai, 200335, China.
  • Zhang Y; Roche Diagnostics (Shanghai) Co., Ltd, Shanghai, 200335, China.
  • Xie L; Yidu Cloud (Beijing) Technology Co., Ltd, Beijing, 100083, China.
  • Niu Z; Yidu Cloud (Beijing) Technology Co., Ltd, Beijing, 100083, China.
  • Chen W; School of Public Health, Fudan University, Shanghai, 200032, China.
J Comp Eff Res ; 13(4): e230146, 2024 04.
Article en En | MEDLINE | ID: mdl-38415341
ABSTRACT

Aim:

To evaluate the cost-effectiveness of seven screening strategies for chronic hepatitis B (CHB) patients in China.

Methods:

A discrete event simulation model combining a decision tree and Markov structure was developed to simulate a CHB cohort aged ≥40 years on a lifetime horizon and evaluate the costs and health outcomes (quality-adjusted life years [QALYs] gained) of ultrasonography (US), alpha-fetoprotein (AFP), protein induced by vitamin K absence-II (PIVKA-II), AFP+US, AFP+PIVKA-II, GAAD (a diagnostic algorithm based on gender and age combined with results of AFP and PIVKA-II) and GAAD+US. Epidemiologic, clinical performance, utility and cost data were obtained from the literature, expert interviews and real-world data. Uncertainties on key parameters were explored through deterministic and probabilistic sensitivity analyses (DSA and PSA).

Results:

Compared with other strategies, GAAD+US detected the most HCC patients at early stage, and GAAD was the screening strategy with the lowest average cost per HCC case diagnosed. Using 3× China's 2022 GDP per capita ($38,233.34) as the threshold, the three strategies of US, GAAD and GAAD+US formed a cost-effectiveness frontier. Screening with US, GAAD, or GAAD+US was associated with costs of $6110.46, $7622.05 and $8636.32, and QALYs of 13.18, 13.48 and 13.52, respectively. The ICER of GAAD over US was $4993.39/QALY and the ICER of GAAD+US over GAAD was $26,691.45/QALY, which was less than 3× GDP per capita. Both DSA and PSA proved the stability of the results.

Conclusion:

GAAD+US was the most cost-effective strategy for early HCC diagnosis among CHB patients which could be considered as the liver cancer screening scheme for the high-risk population in China.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma Hepatocelular / Hepatitis B Crónica / Neoplasias Hepáticas Límite: Humans / Male País/Región como asunto: Asia Idioma: En Revista: J Comp Eff Res Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma Hepatocelular / Hepatitis B Crónica / Neoplasias Hepáticas Límite: Humans / Male País/Región como asunto: Asia Idioma: En Revista: J Comp Eff Res Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido