PDF(Pubmed)
Abstract：
UNASSIGNED: Timely diagnosis and treatment of hepatitis C virus (HCV) is critical to achieve elimination goals. This study evaluated the cost-effectiveness of point-of-care testing strategies for HCV compared to laboratory-based testing in standard-of-care.
UNASSIGNED: Cost-effectiveness analyses were undertaken from the perspective of Australian Governments as funders by modelling point-of-care testing strategies compared to standard-of-care in needle and syringe programs, drug treatment clinics, and prisons. Point-of-care testing strategies included immediate point-of-care HCV RNA testing and combined point-of-care HCV antibody and reflex RNA testing for HCV antibody positive people (with and without consideration of previous treatment). Sensitivity analyses were performed to investigate the cost per treatment initiation with different testing strategies at different HCV antibody prevalence levels.
UNASSIGNED: The average costs per HCV treatment initiation by point-of-care testing, from A$890 to A$1406, were up to 35% lower compared to standard-of-care ranging from A$1248 to A$1632 depending on settings. The average costs per treatment initiation by point-of-care testing for three settings ranged from A$1080 to A$1406 for RNA, A$960-A$1310 for combined antibody/RNA without treatment history consideration, and A$890-A$1189 for combined antibody/RNA with treatment history consideration. When HCV antibody prevalence was <74%, combined point-of-care HCV antibody and point-of-care RNA testing were the most cost-effective strategies. Modest increases in treatment uptake by 8%-31% were required for immediate point-of-care HCV RNA testing to achieve equivalent cost per treatment initiation compared to standard-of-care.
UNASSIGNED: Point-of-care testing is more cost-effective than standard of care for populations at risk of HCV. Testing strategies combining point-of-care HCV antibody and RNA testing are likely to be cost-effective in most settings.
UNASSIGNED: National Health and Medical Research Council.
UNASSIGNED: Cost-effectiveness analyses were undertaken from the perspective of Australian Governments as funders by modelling point-of-care testing strategies compared to standard-of-care in needle and syringe programs, drug treatment clinics, and prisons. Point-of-care testing strategies included immediate point-of-care HCV RNA testing and combined point-of-care HCV antibody and reflex RNA testing for HCV antibody positive people (with and without consideration of previous treatment). Sensitivity analyses were performed to investigate the cost per treatment initiation with different testing strategies at different HCV antibody prevalence levels.
UNASSIGNED: The average costs per HCV treatment initiation by point-of-care testing, from A$890 to A$1406, were up to 35% lower compared to standard-of-care ranging from A$1248 to A$1632 depending on settings. The average costs per treatment initiation by point-of-care testing for three settings ranged from A$1080 to A$1406 for RNA, A$960-A$1310 for combined antibody/RNA without treatment history consideration, and A$890-A$1189 for combined antibody/RNA with treatment history consideration. When HCV antibody prevalence was <74%, combined point-of-care HCV antibody and point-of-care RNA testing were the most cost-effective strategies. Modest increases in treatment uptake by 8%-31% were required for immediate point-of-care HCV RNA testing to achieve equivalent cost per treatment initiation compared to standard-of-care.
UNASSIGNED: Point-of-care testing is more cost-effective than standard of care for populations at risk of HCV. Testing strategies combining point-of-care HCV antibody and RNA testing are likely to be cost-effective in most settings.
UNASSIGNED: National Health and Medical Research Council.
摘要：
■及时诊断和治疗丙型肝炎病毒（HCV）对于实现消除目标至关重要。这项研究评估了与标准护理中基于实验室的检测相比，丙型肝炎病毒的即时检测策略的成本效益。
■从澳大利亚政府作为资助者的角度进行了成本效益分析，方法是将护理点测试策略与针头和注射器计划中的护理标准进行建模，药物治疗诊所，和监狱。即时测试策略包括即时即时即时即时即时即时即时即时即时即时即时即时即时即时即时即时即时检测HCV抗体和反射RNA测试HCV抗体阳性者（有或不考虑先前的治疗）。进行了敏感性分析，以调查在不同HCV抗体流行水平下使用不同测试策略的每次治疗开始的成本。
■通过即时检测开始的每次HCV治疗的平均费用，从890澳元到1406澳元，根据设置，与1248澳元到1632澳元的护理标准相比，低了35%。通过三个设置的现场护理测试，每个治疗开始的平均成本从1080澳元到1406澳元不等。A$960-A$1310的联合抗体/RNA，不考虑治疗史，和A$890-A$1189的联合抗体/RNA，并考虑治疗史。当HCV抗体患病率<74%时，联合现场护理HCV抗体和现场护理RNA检测是最具成本效益的策略.与标准护理相比，立即即时护理点HCVRNA测试需要治疗摄取适度增加8％-31％，以实现每次治疗开始的同等成本。
■对于有HCV风险的人群，点护理测试比标准护理更具成本效益。在大多数情况下，结合即时HCV抗体和RNA测试的测试策略可能具有成本效益。
■国家卫生与医学研究委员会。
■从澳大利亚政府作为资助者的角度进行了成本效益分析，方法是将护理点测试策略与针头和注射器计划中的护理标准进行建模，药物治疗诊所，和监狱。即时测试策略包括即时即时即时即时即时即时即时即时即时即时即时即时即时即时即时即时即时检测HCV抗体和反射RNA测试HCV抗体阳性者（有或不考虑先前的治疗）。进行了敏感性分析，以调查在不同HCV抗体流行水平下使用不同测试策略的每次治疗开始的成本。
■通过即时检测开始的每次HCV治疗的平均费用，从890澳元到1406澳元，根据设置，与1248澳元到1632澳元的护理标准相比，低了35%。通过三个设置的现场护理测试，每个治疗开始的平均成本从1080澳元到1406澳元不等。A$960-A$1310的联合抗体/RNA，不考虑治疗史，和A$890-A$1189的联合抗体/RNA，并考虑治疗史。当HCV抗体患病率<74%时，联合现场护理HCV抗体和现场护理RNA检测是最具成本效益的策略.与标准护理相比，立即即时护理点HCVRNA测试需要治疗摄取适度增加8％-31％，以实现每次治疗开始的同等成本。
■对于有HCV风险的人群，点护理测试比标准护理更具成本效益。在大多数情况下，结合即时HCV抗体和RNA测试的测试策略可能具有成本效益。
■国家卫生与医学研究委员会。
