Cost-Effectiveness of Strategies for Treatment Timing for Perinatally Acquired Hepatitis C Virus

• DOI: 10.1001/jamapediatrics.2024.0114
• Publication Date: 2024-03-11T15:02:39Z
• Authors: Megan Rose Curtis; Rachel L. Epstein; Pamela Pei; Benjamin P. Linas; Andrea L. Ciaranello
• Keywords: Male; Adolescent; Cost-Benefit Analysis; Hepatitis C, Chronic; Antiviral Agents; Infectious Disease Transmission, Vertical; United States; 03 medical and health sciences; Life Expectancy; 0302 clinical medicine; Pregnancy; Child, Preschool; Humans; Female; Child

Importance Prevalence of chronic hepatitis C virus (HCV) infection among pregnant people is increasing in the US. HCV transmitted vertically 7% to 8% births. Direct-acting antiviral (DAA) therapy was recently approved for children with who are 3 years or older. The clinical and economic impacts early DAA young HCV, compared treating at older ages, unknown. Objective To develop a state-transition model project outcomes perinatally acquired investigate cost-effectiveness various ages. Design, Setting, Participants study team modeled natural history simulate disease progression costs simulated cohort 1000 US from old through death. Added data were analyzed January 5, 2021, July 1, 2022. Interventions strategies offering 8 weeks 3, 6, 12, 18 old, as well comparator never HCV. Main Outcomes Measures interest include life expectancy average lifetime per-person health care costs. Other cases cirrhosis, decompensated hepatocellular carcinoma (HCC). Results projected that associated lower mean ($148 162) than deferring treatment until 6 ($164 292), 12 ($171 909), ($195 374). Projected longest when (78.36 [LYs]) decreased deferral (76.10 LYs), (75.99 (75.46 LYs). In prevented 89 27 HCC, 74 liver-related deaths old. sensitivity analyses, loss follow-up led even greater benefits cost savings earlier treatment. Conclusions Relevance These results showed 3-year-old reduce increase survival age access will be important realizing these benefits.