Premium
Use of hepatitis C‐positive grafts in hepatitis C‐negative liver transplant recipients is cost effective
Author(s) -
Saab Sammy,
Kardashian Ani,
Saggi Satvir,
Choi Gina,
Agopian Vatche,
Tong Myron J.
Publication year - 2018
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13383
Subject(s) - medicine , liver transplantation , hepatitis c , liver disease , cohort , hepatitis c virus , gastroenterology , transplantation , surgery , immunology , virus
Background The number of patients needing liver transplantation (LT) exceeds the number of available allografts. The current opioid epidemic in this country has increased the number of potential donors infected with hepatitis C (HCV). Methods We assessed the incremental cost‐effectiveness ratio (ICER) by comparing the costs and number of liver transplants performed using HCV‐positive and HCV‐negative grafts into patients without HCV infection in a decision analysis model with a 1‐year time horizon. Results The use of HCV‐positive grafts was found to have an ICER below $50 000 across all MELD scores. Using our baseline cohort with a model for end‐stage liver disease (MELD) score of 15‐22, the ICER was $21 233/additional LT performed. As the MELD scores increased, the ICER decreased. Above a MELD score of 23, the use of HCV‐positive grafts became cost saving (‐$115 419). Our model was robust to all variables tested in the sensitivity analyses, except drug costs. Conclusion The results of our decision analysis model highlight the potential pharmacoeconomic benefit of utilizing HCV‐positive grafts in LT candidates who are not infected with HCV. The use of HCV‐positive grafts is at least cost effective and even cost saving in patients with MELD scores above 23.