Samenvatting
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.
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.
| Originele taal-2 | English |
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| Kwalificatie | Doctor of Philosophy |
| Toekennende instantie |
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| Begeleider(s)/adviseur |
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| Datum van toekenning | 24-okt.-2022 |
| Plaats van publicatie | [Groningen] |
| Uitgever | |
| DOI's | |
| Status | Published - 2022 |