Donzelli et al comment on the study by Itoh et al regarding on comparing treat-to-target approaches in patients with diabetic retinopathy with hypercholesterolemia, found no significant decrease in ...cardiovascular events or CV-associated deaths with intensive therapy. The intensive statin therapy targeted LDL-C <70 mg/dL, while the standard one targeted 100-120 mg/dL. An exploratory finding also showed fewer cerebral event.
Summary
Background
The World Health Organization estimated that 90% of the infected people need to be diagnosed and 80% need to be treated to reach the aim of hepatitis C virus (HCV) elimination by ...2030. For this reason, all possible strategies to detect and treat HCV‐infected people need to be carefully evaluated to implement the best one.
Aim
To review and synthesise the economic evaluations of HCV screening programs conducted in the era of direct‐acting antiviral agents regimens.
Methods
A systematic literature review was conducted until April 2018 to provide information on the costs and effectiveness of HCV screenings in direct‐acting antiviral agents era. A critical assessment of the quality of economic evaluations retrieved was conducted.
Results
The literature search identified 716 references; 17 of them assessed cost and effectiveness of screening programs and antiviral treatments in different populations: general population (n = 7), drug users (n = 5), high‐risk populations (n = 4) and other populations (n = 3). The HCV screening and direct‐acting antiviral agents treatment appear to be good value for money, both in general and high‐risk populations, if a cost per quality adjusted life years of $50 000 is set as willingness to pay threshold. Some studies showed the value of including lower stage of fibrosis in the treatment selection criteria.
Conclusions
Several HCV screening strategies plus direct‐acting antiviral agents treatments resulted cost‐effectiveness in different populations. However, there is still need of country and population‐specific evaluations within the different HCV screening and treatment strategies available, in order to assess their cost‐effectiveness and sustainability and fully support an evidence‐informed policy for HCV elimination.
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