The quest for a cure for chronic hepatitis B from an HTA perspective: lessons learned from chronic hepatitis c

Urbano Sbarigia

    Research output: ThesisThesis fully internal (DIV)

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    Abstract

    Despite the availability of treatments and vaccines, chronic hepatitis B (CHB) is among the world's deadliest infectious diseases and a global public health concern.

    This thesis focuses on the quest for curative treatments for CHB from a Health Technology Assessment (HTA) perspective and the evidence/data required by HTA and reimbursement bodies to evaluate new products.

    New direct antivirals have recently been introduced for hepatitis C and this experience can be built on in hepatitis B, although there are both similarities and differences between hepatitis C and B viruses and related chronic diseases.
    The second and third chapters focus on hepatitis C with possible directions for future research and development on CHB.

    Chapter 4 concerns an analysis of data on US Veterans patients, showing the high clinical and economic burden of CHB in this population.
    Chapter 5 highlights that self-stigma and social stigma are common among patients living with CHB.
    Chapter 6 addresses patient preferences and shows that one of the main desired attributes of new treatments is limited duration and the ability to achieve sustained HBsAg loss.
    Chapters 7 and 8 describe a network meta-analysis of clinical trials in CHB, and a systematic review of the literature about health economics models; these findings can be used to adapt cost-effectiveness models.

    Adequate collection and provision of the data required by HTA agencies and payers and learning from experience in hepatitis C will optimize patient access to new treatments for HBV and accelerate WHO's ambitious goal of eliminating viral hepatitis.
    Original languageEnglish
    QualificationDoctor of Philosophy
    Awarding Institution
    • University of Groningen
    Supervisors/Advisors
    • Postma, Maarten, Supervisor
    • Wilschut, Jan, Supervisor
    Award date24-Oct-2022
    Place of Publication[Groningen]
    Publisher
    DOIs
    Publication statusPublished - 2022

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