Dataset Information

Cost-effectiveness of different monitoring strategies in a screening and treatment programme for hepatitis B in The Gambia.

ABSTRACT:

Background

Clinical management of chronic hepatitis B virus (HBV) infection is complex and access to antiviral treatment remains limited in sub-Saharan Africa. International guidelines recommend monitoring at least annually for disease progression among HBV-infected people not meeting treatment criteria at initial diagnosis. This study aimed to assess the impact and cost-effectiveness of alternative strategies for monitoring.

Methods

We used a mathematical model of HBV transmission and natural history, calibrated to all available West African data, to project the population-level health impact, costs and cost-effectiveness of different monitoring strategies for HBV-infected individuals not initially eligible for antiviral treatment. We assumed that these patients were found in the year 2020 in a hypothetical community-based screening programme in The Gambia. Monitoring frequencies were varied between every 5 and every 1 year and targeted different age groups.

Results

The currently recommended annual monitoring frequency was likely to be not cost-effective in comparison with other strategies in this setting. 5-yearly monitoring in 15-45-year olds, at US$338 per disability-adjusted life year averted, had the highest probability of being the most effective cost-effective monitoring strategy.

Conclusions

Monitoring less frequently than once a year is a cost-effective strategy in a community-based HBV screening and treatment programme in The Gambia, with the optimal strategy depending on the cost-effectiveness threshold. Efficiencies may be gained by prioritising the 15-45-year age group for more intensive monitoring.

SUBMITTER: Schmit N

PROVIDER: S-EPMC9853089 | biostudies-literature | 2023 Jan

REPOSITORIES: biostudies-literature

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Publications

Cost-effectiveness of different monitoring strategies in a screening and treatment programme for hepatitis B in The Gambia.

Schmit Nora N Nayagam Shevanthi S Lemoine Maud M Ndow Gibril G Shimakawa Yusuke Y Thursz Mark R MR Hallett Timothy B TB

Journal of global health 20230120

<h4>Background</h4>Clinical management of chronic hepatitis B virus (HBV) infection is complex and access to antiviral treatment remains limited in sub-Saharan Africa. International guidelines recommend monitoring at least annually for disease progression among HBV-infected people not meeting treatment criteria at initial diagnosis. This study aimed to assess the impact and cost-effectiveness of alternative strategies for monitoring.<h4>Methods</h4>We used a mathematical model of HBV transmissio ...[more]

PMID: 36655869

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Dataset Information

Cost-effectiveness of different monitoring strategies in a screening and treatment programme for hepatitis B in The Gambia.

Background

Methods

Results

Conclusions

Publications

Cost-effectiveness of different monitoring strategies in a screening and treatment programme for hepatitis B in The Gambia.

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