OP-9 Assessing the Burden and Budget Impacts of HCV Elimination Strategies in Uruguay Using Decision-Analytic Modeling
Conflict of interest: Yes, Coalition For Global Hepatitis Elimination support the project Introduction and Objectives: Background: WHO aims for HCV elimination by 2030, targeting a 80% reduction in incidence and a 65% reduction in mortality, with 90% diagnosed and 80% treatment coverage compared to...
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Elsevier
2024-12-01
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| Series: | Annals of Hepatology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268124003909 |
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| author | Victoria Mainardi Rial Daniela Olivari Solange Gerona Alec Aron Huaiyang Zhong Jagpreet Chhatwal Lindsey Hiebert John Ward |
| author_facet | Victoria Mainardi Rial Daniela Olivari Solange Gerona Alec Aron Huaiyang Zhong Jagpreet Chhatwal Lindsey Hiebert John Ward |
| author_sort | Victoria Mainardi Rial |
| collection | DOAJ |
| description | Conflict of interest: Yes, Coalition For Global Hepatitis Elimination support the project Introduction and Objectives: Background: WHO aims for HCV elimination by 2030, targeting a 80% reduction in incidence and a 65% reduction in mortality, with 90% diagnosed and 80% treatment coverage compared to 2015. Uruguay, with a population of 3.4 million, has low HCV prevalence and universal treatment access, but testing and treatment rates are low. Objective: To assess the feasibility of HCV elimination and compare the burden and budget impacts of various testing strategies in Uruguay. Patients / Materials and Methods: Methods: Disease burden and budget impact projections were generated using a decision-analytic model, The Hep C Elimination Tool, developed by Massachusetts General Hospital with support from the Coalition for Global Hepatitis Elimination and calibrated with Uruguayan parameters. Results and Discussion: With 100% follow-up for confirmatory testing and treatment initiation, 42 strategies meet three elimination goals by 2030.The strategy with the greatest death reductionuses a 30% annual screening rate and 80% treatment rate, requiring 3,220,000 people to be tested (800,000/annual from 2024-2026) and 20,000 treated (5,000/annual from 2024-2026) by 2030. This achieves 91% diagnosis and treatment coverage, with reductions in incidence of 89%, prevalence of 91%, decompensated cirrhosis of 74%, HCC of 46% and mortality of 56%, costing $121.63 million from 2022-2050.The most gradual strategy uses a 15% annual screening rate and 70% treatment rate, requiring 3,190,000 people to be tested (400,000/annual from 2023-2029) and 19,035 treated (2,500/annual from 2024-2029) by 2030. This achieves 90% diagnosis and 85% treatment coverage, with reductions in incidence of 82%, prevalence of 85%, decompensated cirrhosis of 66%, HCC of 34% and mortality of 30%, costing $132.92 million from 2022-2050. Conclusions: Uruguay can achieve WHO HCV elimination incidence goal and diagnosis and treatment targets by 2030. Mathematical modeling can inform policymakers about the impact of different interventions on HCV burden, supporting informed and cost-effective decision-making. |
| format | Article |
| id | doaj-art-00d8235dba1f40088a43e5320511a1b7 |
| institution | OA Journals |
| issn | 1665-2681 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
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| series | Annals of Hepatology |
| spelling | doaj-art-00d8235dba1f40088a43e5320511a1b72025-08-20T02:37:28ZengElsevierAnnals of Hepatology1665-26812024-12-012910160710.1016/j.aohep.2024.101607OP-9 Assessing the Burden and Budget Impacts of HCV Elimination Strategies in Uruguay Using Decision-Analytic ModelingVictoria Mainardi Rial0Daniela Olivari1Solange Gerona2Alec Aron3Huaiyang Zhong4Jagpreet Chhatwal5Lindsey Hiebert6John Ward7Programa Nacional de Trasplante Hepático URUGUAY, Montevideo, UruguayPrograma Nacional de Trasplante Hepático URUGUAY, Montevideo, UruguayPrograma Nacional de Trasplante Hepático URUGUAY, Montevideo, UruguayMassachusetts General Hospital Institute for Technology Assessment, Boston, Estados Unidos (EEUU)Massachusetts General Hospital Institute for Technology Assessment, Boston, Estados Unidos (EEUU)Massachusetts General Hospital Institute for Technology Assessment, Boston, Estados Unidos (EEUU)Coalition for Global Hepatitis Elimination, Task Force for Global Health, Decatur, Estados Unidos (EEUU)Coalition for Global Hepatitis Elimination, Task Force for Global Health, Decatur, Estados Unidos (EEUU)Conflict of interest: Yes, Coalition For Global Hepatitis Elimination support the project Introduction and Objectives: Background: WHO aims for HCV elimination by 2030, targeting a 80% reduction in incidence and a 65% reduction in mortality, with 90% diagnosed and 80% treatment coverage compared to 2015. Uruguay, with a population of 3.4 million, has low HCV prevalence and universal treatment access, but testing and treatment rates are low. Objective: To assess the feasibility of HCV elimination and compare the burden and budget impacts of various testing strategies in Uruguay. Patients / Materials and Methods: Methods: Disease burden and budget impact projections were generated using a decision-analytic model, The Hep C Elimination Tool, developed by Massachusetts General Hospital with support from the Coalition for Global Hepatitis Elimination and calibrated with Uruguayan parameters. Results and Discussion: With 100% follow-up for confirmatory testing and treatment initiation, 42 strategies meet three elimination goals by 2030.The strategy with the greatest death reductionuses a 30% annual screening rate and 80% treatment rate, requiring 3,220,000 people to be tested (800,000/annual from 2024-2026) and 20,000 treated (5,000/annual from 2024-2026) by 2030. This achieves 91% diagnosis and treatment coverage, with reductions in incidence of 89%, prevalence of 91%, decompensated cirrhosis of 74%, HCC of 46% and mortality of 56%, costing $121.63 million from 2022-2050.The most gradual strategy uses a 15% annual screening rate and 70% treatment rate, requiring 3,190,000 people to be tested (400,000/annual from 2023-2029) and 19,035 treated (2,500/annual from 2024-2029) by 2030. This achieves 90% diagnosis and 85% treatment coverage, with reductions in incidence of 82%, prevalence of 85%, decompensated cirrhosis of 66%, HCC of 34% and mortality of 30%, costing $132.92 million from 2022-2050. Conclusions: Uruguay can achieve WHO HCV elimination incidence goal and diagnosis and treatment targets by 2030. Mathematical modeling can inform policymakers about the impact of different interventions on HCV burden, supporting informed and cost-effective decision-making.http://www.sciencedirect.com/science/article/pii/S1665268124003909 |
| spellingShingle | Victoria Mainardi Rial Daniela Olivari Solange Gerona Alec Aron Huaiyang Zhong Jagpreet Chhatwal Lindsey Hiebert John Ward OP-9 Assessing the Burden and Budget Impacts of HCV Elimination Strategies in Uruguay Using Decision-Analytic Modeling Annals of Hepatology |
| title | OP-9 Assessing the Burden and Budget Impacts of HCV Elimination Strategies in Uruguay Using Decision-Analytic Modeling |
| title_full | OP-9 Assessing the Burden and Budget Impacts of HCV Elimination Strategies in Uruguay Using Decision-Analytic Modeling |
| title_fullStr | OP-9 Assessing the Burden and Budget Impacts of HCV Elimination Strategies in Uruguay Using Decision-Analytic Modeling |
| title_full_unstemmed | OP-9 Assessing the Burden and Budget Impacts of HCV Elimination Strategies in Uruguay Using Decision-Analytic Modeling |
| title_short | OP-9 Assessing the Burden and Budget Impacts of HCV Elimination Strategies in Uruguay Using Decision-Analytic Modeling |
| title_sort | op 9 assessing the burden and budget impacts of hcv elimination strategies in uruguay using decision analytic modeling |
| url | http://www.sciencedirect.com/science/article/pii/S1665268124003909 |
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