Systematic Review of Economic Evaluation of the Surveillance Programs for Hepatocellular Carcinoma (HCC) in Chronic Hepatitis B PatientsP. Sangmala, U. Chaikledkaew*and T. Tanwandee
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Liver cancer is the sixth most frequent form of cancer worldwide and is the third leading cause of cancer-related mortality. Many current surveillance programs for HCC have continuously shown to reduce the burden of HCC. However, the cost-effectiveness information of such programs has been still limited. The objective of this study was to systematically review the studies related to economic evaluation of the surveillance program for HCC in chronic hepatitis B patients. Studies comparing cost and outcomes of surveillance program related to HCC in patients with hepatitis B were searched through Pubmed and Cochrane databases during 2001 and 2011. One-hundred and fifteen articles were reviewed and only eligible five full-text articles were included. Five studies were conducted in Italy, the United Kingdom, Taiwan, the Netherlands and the United State. Alternative surveillance strategies were compared with no surveillance program or usual clinical practice. The perspective of healthcare provider, government, or halth system was used. Costs were collected based on the perspective used in the Most studies used model based approach (i.e., decision tree model and/or Markov model), while the study in Italy did not. Incremental cost-effectiveness ratio (i.e., cost per quality-adjusted life year or cost per life year gained) was used to present the cost-effectiveness results. Our systematic review results indicated that the surveillance program related to HCC in patients with hepatitis B would be cost-effective in most developed countries. However, further study should be investigated whether such program would be cost-effective in Thailand, a high prevalence area of hepatitis B.
Keyword:
Economic evaluation, Surveillance program, Liver, Neoplasm, Hepatitis B virus, Hepatocellular carcinoma
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