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Cost-effectiveness of hepatitis C virus (HCV) elimination strategies among people who inject drugs (PWID) in Tijuana, Mexico

dc.creatorMarquez, Lara K.es_ES
dc.creatorFleiz, Claraes_ES
dc.creatorBurgos, Jose Luises_ES
dc.creatorCepeda, Javier A.es_ES
dc.creatorMcIntosh, Craiges_ES
dc.creatorGarfein, Richard S.es_ES
dc.creatorKiene, Susan M.es_ES
dc.creatorBrodine, Stephaniees_ES
dc.creatorStrathdee, Steffanie A.es_ES
dc.creatorMartin, Natasha K.es_ES
dc.date2021
dc.date.accessioned2024-04-15T17:48:12Z
dc.date.available2024-04-15T17:48:12Z
dc.date.issued2021
dc.identifierJC70DIEP21es_ES
dc.identifier.issn0965-2140
dc.identifier.urihttp://repositorio.inprf.gob.mx/handle/123456789/7946
dc.identifier.urihttps://doi.org/10.1111/add.15456
dc.identifier.urihttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8380744/
dc.descriptionBackground and aims: In Latin America, Mexico was first to launch a hepatitis C virus (HCV) elimination strategy, where people who inject drugs (PWID) are a main risk group for transmission. In Tijuana, HCV seroprevalence among PWID is > 90%, with minimal harm reduction (HR). We evaluated cost-effectiveness of strategies to achieve the incidence elimination target among PWID in Tijuana. Methods: Modeling study using a dynamic, cost-effectiveness model of HCV transmission and progression among active and former PWID in Tijuana, to assess the cost-effectiveness of incidence elimination strategies from a health-care provider perspective. The model incorporated PWID transitions between HR stages (no HR, only opioid agonist therapy, only high coverage needle-syringe programs, both). Four strategies that could achieve the incidence target (80% reduction by 2030) were compared with the status quo (no intervention). The strategies incorporated the number of direct-acting anti-viral (DAA) treatments required with: (1) no HR scale-up, (2) HR scale-up from 2019 to 20% coverage among PWID, (3) HR to 40% coverage and (4) HR to 50% coverage. Costs (2019 US$) and health outcomes [disability-adjusted life years (DALYs)] were discounted 3% per year. Mean incremental cost-effectiveness ratios (ICER, $/DALY averted) were compared with one-time per capita gross domestic product (GDP) ($9698 in 2019) and purchasing power parity-adjusted per capita GDP ($4842-13 557) willingness-to-pay (WTP) thresholds. Results: DAAs alone were the least costly elimination strategy [$173 million, 95% confidence interval (CI) = 126-238 million], but accrued fewer health benefits compared with strategies with HR. DAAs + 50% HR coverage among PWID averted the most DALYs but cost $265 million, 95% CI = 210-335 million). The optimal strategy was DAAs + 50% HR (ICER $6743/DALY averted compared to DAAs only) under the one-time per-capita GDP WTP ($9698). Conclusions: A combination of high-coverage harm reduction and hepatitis C virus treatment is the optimal cost-effective strategy to achieve the HCV incidence elimination goal in Mexico.es_ES
dc.formatPDFes_ES
dc.language.isoenges_ES
dc.publisherWiley-Blackwelles_ES
dc.relation116(10):2734-2745
dc.rightsAcceso Cerradoes_ES
dc.titleCost-effectiveness of hepatitis C virus (HCV) elimination strategies among people who inject drugs (PWID) in Tijuana, Mexicoes_ES
dc.typeArtículoes_ES
dc.contributor.affiliationUniversity of California San Diego, La Jolla, CA, USA
dc.contributor.emaillkusnezo@mail.ucsd.edu
dc.relation.jnabreviadoADDICTION
dc.relation.journalAddiction
dc.identifier.placeInglaterra
dc.date.published2021
dc.identifier.organizacionInstituto Nacional de Psiquiatría Ramón de la Fuente Muñiz
dc.identifier.eissn1360-0443
dc.identifier.doi10.1111/add.15456
dc.subject.kwCost-effectiveness
dc.subject.kwHarm reduction
dc.subject.kwHCV
dc.subject.kwModeling
dc.subject.kwPeople who inject drugs
dc.subject.kwPrevention


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