Earlier DAA Treatment in Children with Hepatitis C is Cost-Effective, Study Finds

A new study found that children with hepatitis C virus (HCV) infection, having an early treatment with direct-acting antivirals (DAA) is a more cost-effective option than delaying to adulthood, that may lead to averted cases of cirrhosis, malignancies, and mortality.


Photo: Hepatitis C Virus (HCV) | InStyleHealth


A state-transition model of chronic HCV was generated by researchers, where they were comparing direct-acting antivirals (DAA) treatment initiated at 6 years old vs delaying medication until the age of 18 years.  Results included the expected quality adjusted life-years or QALYs and medical costs in Canadian dollars, comparing between the two scenarios. Existing literature and government statistics were reference sources for the input data in this study.


For children who received an early treatment, 0.1% eventually developed cirrhosis after 20 years. In the same duration, 0.02% died diagnosed with decompensated cirrhosis or hepatocellular carcinoma. Comparatively, 3.4% and 0.45% of children with deferred treatment met the respective outcomes.


However, early treatment in 10,000 children could prevent 330 cases of cirrhosis, 18 of hepatocellular carcinoma, and 43 of liver-related mortality. Correspondingly, such an outcome would yield a 0.63 QALYs gain.


Early treatment with DAAs resulted in an additional cost of CAD$ 7,975 in the base case economic model. This add-on expense was not completely offset by savings from preventing late-stage illness, although the resulting incremental cost-effectiveness ratio was considered effective under a 50k CAD$ per QALY gained threshold.


Researchers stated, “These results therefore support clinical and health policies that broaden treatment access for HCV infection to very young children, which is essential to achieve the global elimination of HCV.”


To view the complete details of the study, click here.


Source: J Pediatr 2021;230:38-45.e2

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