Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/68235
Citations | ||
Scopus | Web of Science® | Altmetric |
---|---|---|
?
|
?
|
Type: | Journal article |
Title: | Cost-effectiveness of universal hepatitis B virus screening in patients beginning chemotherapy for solid tumors |
Author: | Day, F. Karnon, J. Rischin, D. |
Citation: | Journal of Clinical Oncology, 2011; 29(24):3270-3277 |
Publisher: | Amer Soc Clinical Oncology |
Issue Date: | 2011 |
ISSN: | 0732-183X 1527-7755 |
Statement of Responsibility: | Fiona L. Day, Jonathan Karnon and Danny Rischin |
Abstract: | Purpose: Universal screening for chronic hepatitis B virus (HBV) infection before chemotherapy has been recommended. We evaluated the cost-effectiveness of HBV screening before chemotherapy given for nonhematopoietic solid tumors (STs). Methods: A decision-analytic model was used to compare the cost-effectiveness of universal screening conducted per professional guidelines versus no screening in hypothetical patient cohorts beginning adjuvant chemotherapy for early breast cancer or palliative chemotherapy for advanced non–small-cell lung cancer. Survival times were extrapolated using Markov models. Probabilities were derived from published studies and costs estimated from the perspective of the Australian health care system. One-way and probabilistic sensitivity analyses were performed, including with the application of an alternative HBV screening strategy. Results: Using an incremental cost-effectiveness ratio threshold of $50,000 (Australian dollars) per life-year (LY) saved, universal HBV screening was not cost-effective for adjuvant patients ($88,224/LY, 13% probability of being cost-effective), palliative patients ($1,344,251/LY, 0%), or pooled (all) patients ($149,857/LY, 1%). Sensitivity analyses found that screening approached cost-effectiveness among adjuvant patients with the highest reported rates of undiagnosed chronic HBV (65%, $59,445/LY) or HBV reactivation with chemotherapy (41%, $56,537/LY). Cost- effectiveness was also significantly influenced by HBV population prevalence. An alternative screening strategy using hepatitis B surface antigen testing only produced the most economically favorable results, with $30,126/LY (80% probability) for adjuvant patients and $51,201/LY (43%) for the pooled cohort. Conclusion: Universal HBV screening conducted per current guidelines is not cost-effective in patients with STs. Screening may be economically favorable in selected patient subpopulations and/or with simplification of the screening strategy. |
Keywords: | Humans Hepatitis B, Chronic Neoplasms Mass Screening Chemotherapy, Adjuvant Decision Support Techniques Adult Cost-Benefit Analysis Australia |
Rights: | © 2011 by American Society of Clinical Oncology |
DOI: | 10.1200/JCO.2011.35.1635 |
Published version: | http://dx.doi.org/10.1200/jco.2011.35.1635 |
Appears in Collections: | Aurora harvest 5 Public Health publications |
Files in This Item:
There are no files associated with this item.
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.