Eficiencia de diversas estrategias para el diagnóstico de la hepatitis C en un solo paso
- Javier Crespo García 1
- José María Eiros Bouza 2
- Antonio Javier Blasco Bravo
- Pablo Lázaro de Mercado
- Antonio Aguilera Guirao 3
- Federico García 4
- Javier García-Samaniego Rey 5
- José Luis Calleja Panero 6
- 1 Hospital Universitario Marqués de Valdecilla. Santander
- 2 Hospital Universitario Río Hortega. Valladolid
- 3 Complejo Hospitalario Universitario de Santiago. A Coruña
- 4 Hospital Universitario San Cecilio.Granada
- 5 Hospital Universitario La Paz. Madrid
- 6 Hospital Universitario Puerta de Hierro. Majadahonda, Madrid
ISSN: 2340-416, 1130-0108
Ano de publicación: 2019
Volume: 111
Número: 1
Páxinas: 10-16
Tipo: Artigo
Outras publicacións en: Revista Española de Enfermedades Digestivas
Resumo
Background: implementing one-step strategies for hepatitis C diagnosis would help shorten the time to treatment access. Thus avoiding disease progression and complications, while facilitating hepatitis C virus (HCV) elimination. Objective: to assess the validity and certainty of potential one-step strategies for the diagnosis of HCV infection and their associated cost and efficiency. Methods: the study design is an economic appraisal of efficiency (cost/efficacy) using decision trees and deterministic sensitivity analysis. The analysis was performed from the payer perspective (Spanish National Health System), which exclusively considers the direct costs. Only the differential costs (diagnostic testing costs) were taken into account and the study was set in Spain. The efficacy of a diagnostic strategy was defined as the percentage of patients with an active HCV infection who received a positive diagnosis and the efficiency was defined as the cost per patient with a correctly diagnosed and active infection. Results: the one-step strategies evaluated for the diagnosis of HCV had an acceptable validity and certainty due to the high sensitivity and specificity of the considered tests. The Ab-Ag strategy was the most efficient, followed by Ab-Ag-VL and Ab-VL. Ab-Ag was the most efficient due to the lower cost per patient tested, although the efficacy was lower than the Ab-VL efficacy. Conclusion: the study findings may help to establish more appropriate one-step diagnostic approaches whilst considering the efficacy and efficiency.