Economic evaluation of hepatocellular carcinoma surveillance in chronic hepatitis B patients with virological remission.
Cost-effectiveness
Liver cancer
Microsimulation modeling
Screening
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
13 Aug 2024
13 Aug 2024
Historique:
received:
24
04
2024
accepted:
01
08
2024
medline:
14
8
2024
pubmed:
14
8
2024
entrez:
13
8
2024
Statut:
epublish
Résumé
Subsequent risk of hepatocellular carcinoma (HCC) persists in chronic hepatitis B (CHB) patients with virological remission. We aimed to assess the cost-effectiveness of HCC surveillance in those patients and determine appropriate age to commence or discontinue surveillance. We developed an individual-based state transition model, simulating the advancement of HCC in CHB patients with virological remission. We used this model to compare the incremental cost-effectiveness ratio (ICER) and long-term health outcomes of biannual or annual HCC surveillance for varying durations with no surveillance. For compensated cirrhosis patients with CHB, biannual surveillance was not cost-effective for all age groups, while annual surveillance was cost-effective for patients aged 55 to 70 (ICER USD 28,076 / quality-adjusted life years [QALY] gained), which detected 176 additional early HCC cases in a 100,000-person cohort compared to no surveillance. In CHB patients with advanced fibrosis, annual surveillance for patients aged 40 to 75 was the most cost-effective strategy (ICER USD 4,984/QALY gained), which detected 289 additional early HCC per 100,000 patients. Annual surveillance for patients with compensated cirrhosis or advanced fibrosis was a more cost-effective option that demonstrated substantial economic benefits, being slightly less effective than biannual surveillance at a significantly lower cost, providing insights for professionals in evaluating HCC surveillance among high-risk patients in China. The most cost-effective age group for surveillance of hepatocellular carcinoma (HCC) varied depending on the stage of the disease. Regular annual surveillance for patients with compensated cirrhosis or advanced fibrosis was more cost-effective option, showing great economic and clinical benefits with slightly less effective than biannual surveillance but significantly lower cost.
Sections du résumé
BACKGROUND
BACKGROUND
Subsequent risk of hepatocellular carcinoma (HCC) persists in chronic hepatitis B (CHB) patients with virological remission. We aimed to assess the cost-effectiveness of HCC surveillance in those patients and determine appropriate age to commence or discontinue surveillance.
METHODS
METHODS
We developed an individual-based state transition model, simulating the advancement of HCC in CHB patients with virological remission. We used this model to compare the incremental cost-effectiveness ratio (ICER) and long-term health outcomes of biannual or annual HCC surveillance for varying durations with no surveillance.
RESULTS
RESULTS
For compensated cirrhosis patients with CHB, biannual surveillance was not cost-effective for all age groups, while annual surveillance was cost-effective for patients aged 55 to 70 (ICER USD 28,076 / quality-adjusted life years [QALY] gained), which detected 176 additional early HCC cases in a 100,000-person cohort compared to no surveillance. In CHB patients with advanced fibrosis, annual surveillance for patients aged 40 to 75 was the most cost-effective strategy (ICER USD 4,984/QALY gained), which detected 289 additional early HCC per 100,000 patients.
CONCLUSIONS
CONCLUSIONS
Annual surveillance for patients with compensated cirrhosis or advanced fibrosis was a more cost-effective option that demonstrated substantial economic benefits, being slightly less effective than biannual surveillance at a significantly lower cost, providing insights for professionals in evaluating HCC surveillance among high-risk patients in China.
The most cost-effective age group for surveillance of hepatocellular carcinoma (HCC) varied depending on the stage of the disease. Regular annual surveillance for patients with compensated cirrhosis or advanced fibrosis was more cost-effective option, showing great economic and clinical benefits with slightly less effective than biannual surveillance but significantly lower cost.
Autres résumés
Type: plain-language-summary
(eng)
The most cost-effective age group for surveillance of hepatocellular carcinoma (HCC) varied depending on the stage of the disease. Regular annual surveillance for patients with compensated cirrhosis or advanced fibrosis was more cost-effective option, showing great economic and clinical benefits with slightly less effective than biannual surveillance but significantly lower cost.
Identifiants
pubmed: 39138480
doi: 10.1186/s12889-024-19670-9
pii: 10.1186/s12889-024-19670-9
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2202Subventions
Organisme : National Natural Science Foundation of China
ID : 72374179
Organisme : Zhejiang University K. P. Chao's High Technology Development Foundation
ID : 2022RC017
Organisme : Mega-Project of National Science and Technology for the 13th Five-Year Plan of China
ID : 2018ZX10721102-003-006
Organisme : Fundamental Research Funds for the Central Universities
ID : K20210205
Informations de copyright
© 2024. The Author(s).
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