| Titre : | Evaluating the cost-effectiveness of existing needle and syringe programmes in preventing hepatitis C transmission in people who inject drugs (2019) |
| Auteurs : | S. SWEENEY ; Z. WARD ; L. PLATT ; L. GUINNESS ; M. HICKMAN ; V. HOPE ; L. MAHER ; J. IVERSEN ; S. J. HUTCHINSON ; J. SMITH ; R. AYRES ; I. HAINEY ; P. VICKERMAN |
| Type de document : | Article : Périodique |
| Dans : | Addiction (Vol.114, n°3, March 2019) |
| Article en page(s) : | 560-570 |
| Note générale : |
Letters to the Editor:
- Monitoring emerging prescription-drug related harms: a comment on Cairns et al. Arunogiri S., Crossin R., Scott D., Lubman D.I., p. 571-572. - Monitoring emerging prescription-drug related harms: a comment on Cairns et al. - in reply. Cairns R., Schaffer A.L., Ryan N., Pearson S.A., Buckley N.A., p. 572-573. |
| Langues: | Anglais |
| Discipline : | MAL (Maladies infectieuses / Infectious diseases) |
| Mots-clés : |
Thésaurus Géographique ROYAUME-UNIThésaurus TOXIBASE HEPATITE ; COUT ; EFFICACITE ; PROGRAMME ; ECHANGE DE SERINGUES ; EVALUATION ; USAGER ; INJECTION ; REDUCTION DES RISQUES ET DES DOMMAGES ; ECONOMIE ; MODELE STATISTIQUE ; INFECTION |
| Résumé : |
AIM: To evaluate the cost-effectiveness of needle and syringe programmes (NSPs) compared with no NSPs on hepatitis C virus (HCV) transmission in the United Kingdom.
DESIGN: Cost-effectiveness analysis from a National Health Service (NHS)/health-provider perspective, utilizing a dynamic transmission model of HCV infection and disease progression, calibrated using city-specific surveillance and survey data, and primary data collection on NSP costs. The effectiveness of NSPs preventing HCV acquisition was based on empirical evidence. SETTING AND PARTICIPANTS: UK settings with different chronic HCV prevalence among people who inject drugs (PWID): Dundee (26%), Walsall (18%) and Bristol (45%). INTERVENTIONS: Current NSP provision is compared with a counterfactual scenario where NSPs are removed for 10 years and then returned to existing levels with effects collected for 40 years. MEASUREMENTS: HCV infections and cost per quality-adjusted life year (QALY) gained through NSPs over 50 years. FINDINGS: Compared with a willingness-to-pay threshold of £20 000 per QALY gained, NSPs were highly cost-effective over a time-horizon of 50 years and decreased the number of HCV incident infections. The mean incremental cost-effectiveness ratio was cost-saving in Dundee and Bristol, and £596 per QALY gained in Walsall, with 78, 46 and 40% of simulations being cost-saving in each city, respectively, with differences driven by coverage of NSP and HCV prevalence (lowest in Walsall). More than 90% of simulations were cost-effective at the willingness-to-pay threshold. Results were robust to sensitivity analyses, including varying the time-horizon, HCV treatment cost and numbers of HCV treatments per year. CONCLUSIONS: Needle and syringe programmes are a highly effective low-cost intervention to reduce hepatitis C virus transmission, and in some settings they are cost-saving. Needle and syringe programmes are likely to remain cost-effective irrespective of changes in hepatitis C virus treatment cost and scale-up. |
| Domaine : | Drogues illicites / Illicit drugs |
| Refs biblio. : | 57 |
| Affiliation : | Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK |
| Cote : | Abonnement |
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