Purpose
To estimate the prevalence chronic hepatitis C (CHC) and to determine the clinical-effectiveness, cost-effectiveness, and affordability of different HCV treatment prioritization strategies for all Canadian provinces.
Research Questions
1. What are the prevalence of CHC and the number of untreated individuals for each province in Canada?
2. What is the financial impact to the provincial formulary with the current restricted reimbursement scenario?
3. When is the best time and what is the best strategy to ease the reimbursement restricted criteria?
4. What will be the financial impact to the provincial formulary after easing reimbursement criteria?
5. When is the best time to phase in hepatitis C population screening in order to identify undiagnosed individuals?
6. What is the financial impact to the provincial formulary once hepatitis C population screening is in place?
Design and Methods
A five-step modeling project to estimate the prevalence, the number of untreated individuals, and to determine the clinical effectiveness, cost-effectiveness, and affordability of different hepatitis C virus (HCV) treatment prioritization strategies for all Canadian provinces, using data from cancer registries, administrative health care databases, expert committee discussions and literature reviews. The study will use a state-transition model to estimate the prevalence and an individual-level state transition model for cost-effectiveness analysis (CEA) of different screening and treatment prioritization strategies. For each strategy explored, the study will perform comprehensive budget impact analysis (BIA) for each province.
Step I – Expert Committee
Step II - Retrospective Cohort Study Utilizing Administrative Data
Step III - Estimate the prevalence using a backpropagation model
Step IV - Policy model for chronic hepatitis C (CHC) treatment prioritizing options
Step V - Comprehensive Budget Impact Analyses for Canadian Provinces
Progress
The back-calculation model has been set up and its implementation and calibration is in progress.
Study Timeline
November 2016 – October 2019
Research Team
Murray Krahn, MD, MSc, FRCPC
William Wong, PhD
Valeria Rac, MD, PhD
Abdullah Hamadeh, PhD
Alex Haines, MSc
.Josephine Wong, MD
Funding
Canadian Liver Foundation Grant
Publications / Presentations