Journal article
Cost-effectiveness of using hepatitis C viremic hearts for transplantation into HCV-negative recipients
American journal of transplantation, Vol.21(2), pp.657-668
02/01/2021
DOI: 10.1111/ajt.16245
PMCID: PMC8216294
PMID: 32777173
Abstract
Outcomes following hepatitis C virus (HCV)-viremic heart transplantation into HCV-negative recipients with HCV treatment are good. We assessed cost-effectiveness between cohorts of transplant recipients willing and unwilling to receive HCV-viremic hearts. Markov model simulated long-term outcomes among HCV-negative patients on the transplant waitlist. We compared costs (2018 USD) and health outcomes (quality-adjusted life-years, QALYs) between cohorts willing to accept any heart and those willing to accept only HCV-negative hearts. We assumed 4.9% HCV-viremic donor prevalence. Patients receiving HCV-viremic hearts were treated, assuming $39 600/treatment with 95% cure. Incremental cost-effectiveness ratios (ICERs) were compared to a $100 000/QALY gained willingness-to-pay threshold. Sensitivity analyses included stratification by blood type or region and potential negative consequences of receipt of HCV-viremic hearts. Compared to accepting only HCV-negative hearts, accepting any heart gained 0.14 life-years and 0.11 QALYs, while increasing costs by $9418/patient. Accepting any heart was cost effective (ICER $85 602/QALY gained). Results were robust to all transplant regions and blood types, except type AB. Accepting any heart remained cost effective provided posttransplant mortality and costs among those receiving HCV-viremic hearts were not >7% higher compared to HCV-negative hearts. Willingness to accept HCV-viremic hearts for transplantation into HCV-negative recipients is cost effective and improves clinical outcomes.
Details
- Title: Subtitle
- Cost-effectiveness of using hepatitis C viremic hearts for transplantation into HCV-negative recipients
- Creators
- Cathy Logan - University of California, San DiegoIly Yumul - University of IowaJavier Cepeda - University of California, San DiegoVictor Pretorius - University of California, San DiegoEric Adler - University of California, San DiegoSaima Aslam - University of California, San DiegoNatasha K. Martin - University of Bristol
- Resource Type
- Journal article
- Publication Details
- American journal of transplantation, Vol.21(2), pp.657-668
- Publisher
- Wiley
- DOI
- 10.1111/ajt.16245
- PMID
- 32777173
- PMCID
- PMC8216294
- ISSN
- 1600-6135
- eISSN
- 1600-6143
- Number of pages
- 12
- Grant note
- R01 AI147490 / National Institute for Allergy and Infectious Diseases; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Allergy & Infectious Diseases (NIAID) 234-2005-37011C / Health Resources and Services Administration; United States Department of Health & Human Services; United States Health Resources & Service Administration (HRSA) P30 AI036214 / University of California San Diego Center for AIDS Research K01DA043421 / National Institute for Drug Abuse; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Drug Abuse (NIDA)
- Language
- English
- Date published
- 02/01/2021
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984359856502771
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