H Razavi April 13 2016 HCV Economic impact models have been developed for 15 countries regions Africa Americas Asia Pacific Europe Ethiopia Mexico Egypt Croatia Ghana British ID: 929964
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Slide1
Economic Impact of Eliminating HCV
H.
Razavi
April 13, 2016
Slide2HCV Economic impact models have been developed for 15
countries/ regions
Africa
Americas
Asia/ Pacific
Europe
Ethiopia
Mexico
Egypt
Croatia
Ghana
British
Columbia
Japan
Switzerland
Nigeria
Malaysia
Spain
Mongolia
Greece
Saudi Arabia
Viet Nam
Slide3Methodology
Direct Costs
Healthcare costs (outpatient, inpatient, medical cost excluding HCV treatment)
Laboratory costs – screening, PCR, viral load, staging, genotyping, other
Current and future cost of therapies (DAAs, Peg IFN, traditional medicine)
Private vs. public
Patient co-pay
Indirect Costs
Years living with disability
Years of life lost
Converted to an economic value using gross national income (GNI) per capita for ages
Scenarios
WHO recommendation / elimination
Drop in generic drug prices over time
Simplifying laboratory procedures
Slide4Ethiopia Economic Impact Analysis - Assumptions
Annual Cost per
Diagnosed
Patient - USD
Public Cost
Private Cost
Annual
Follow-up Cost (F0-F3) 601 857 Compensated Cirrhosis685 1,028 Decompensated Cirrhosis3,400 5,100 Hepatocellular Carcinoma4,900 7,350
Diagnostic Costs - USD
Public
Private
Anti-HCV
13
20
RNA
Test/ PCR
120
180
Genotyping
70
105
Staging
/ Liver Biopsy/
Fibroscan
250
375
Slide5Economic Impact of HCV Treatment – Direct Costs
Slide6Economic Impact of HCV Treatment – Direct & Indirect Costs
Slide7Breakeven analysis - Ethiopia
Breakeven
Slide8In every country we have analyzed, treatment is more cost saving than status quo
Estes C, Abdel-Kareem M, Abdel-
Razek
W, Abdel-
Sameea
E,
Abuzeid
M,
Gomaa A, et al. Economic burden of hepatitis C in Egypt: the future impact of highly effective therapies. Aliment Pharmacol Ther 2015 Jul 22.Egypt (Total Direct & Indirect Costs)EliminationStatus Quo in 2014Mongolia (Total Direct & Indirect Costs)EliminationStatus Quo in 2015
Slide9This is not limited to low & middle income countries – in high income countries the healthcare costs & cost per life year is higher
Breakeven
Breakeven
Saudi Arabia
Slide10Negotiating drug prices is important, but the central issue facing HCV elimination is how to pay for it now & recover investment later
Mongolia
Current spending on Treatment of HCC & Cirrhosis & Diagnosis
Slide11Conclusions:
60% of all HCV infected individuals can have access to generic DAAs TODAY
We need good healthcare and diagnostic costs to estimate the economic burden of HCV and cost effectiveness of drugs and diagnostics
The laboratory/ testing requirements for HCV treatment need to be simplified, simplified, simplified
The cost of diagnostics needs to be examined closely in low income countries
Central issue facing HCV elimination is how to pay for it now & recover investment later