Economic Impact of European Liver and Intestine Transplantation Association (ELITA) Recommendations for Hepatitis B Prophylaxis After Liver Transplantation

Paolo Cortesi (), Raffaella Viganò, Sara Conti, Ilaria Lenci, Riccardo Volpes, Silvia Martini, Mario Angelico, James Fung, Maria Buti, Audrey Coilly, Francois Durand, Constantino Fondevila, Pascal Lebray, Frederik Nevens, Wojciech Polak, Mario Rizzetto, Fabien Zoulim (), Giovanni Perricone, Marina Berenguer, Lorenzo Mantovani, Christophe Duvoux and Luca Belli
Additional contact information
Paolo Cortesi: UNIMIB - Università degli Studi di Milano-Bicocca = University of Milano-Bicocca
Raffaella Viganò: ASST Great Metropolitan Niguarda / ASST Grande Ospedale Metropolitano Niguarda [Milan, Italia]
Sara Conti: UNIMIB - Università degli Studi di Milano-Bicocca = University of Milano-Bicocca
Ilaria Lenci: Università degli Studi di Roma Tor Vergata [Roma, Italia] = University of Rome Tor Vergata [Rome, Italy] = Université de Rome Tor Vergata [Rome, Italie]
Riccardo Volpes: ISMETT - Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione
Silvia Martini: UNITO - Università degli studi di Torino = University of Turin
Mario Angelico: Università degli Studi di Roma Tor Vergata [Roma, Italia] = University of Rome Tor Vergata [Rome, Italy] = Université de Rome Tor Vergata [Rome, Italie]
James Fung: HKU - The University of Hong Kong
Maria Buti: Vall d'Hebron University Hospital [Barcelona], ISCIII - Instituto de Salud Carlos III [Madrid]
Audrey Coilly: CHB - Centre Hépato-Biliaire [Hôpital Paul Brousse] - Hôpital Paul Brousse - Assistance Publique - Hôpitaux de Paris, Physiopathologie et traitement des maladies du foie - Hôpital Paul Brousse - INSERM - Institut National de la Santé et de la Recherche Médicale - Université Paris-Saclay
Francois Durand: Hôpital Beaujon [AP-HP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP), CRI (UMR_S_1149 / ERL_8252 / U1149) - Centre de recherche sur l'Inflammation - INSERM - Institut National de la Santé et de la Recherche Médicale - CNRS - Centre National de la Recherche Scientifique - UPCité - Université Paris Cité
Constantino Fondevila: Hospital Universitario La Paz-Carlos III [Madrid]
Pascal Lebray: CHU Pitié-Salpêtrière [AP-HP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - SU - Sorbonne Université, SU - Sorbonne Université
Frederik Nevens: University Hospitals Leuven [Leuven]
Wojciech Polak: Erasmus MC - Erasmus University Medical Center [Rotterdam]
Mario Rizzetto: UNITO - Università degli studi di Torino = University of Turin
Fabien Zoulim: UNICANCER/CRCL - Centre de Recherche en Cancérologie de Lyon - Centre Léon Bérard [Lyon] - UCBL - Université Claude Bernard Lyon 1 - Université de Lyon - INSERM - Institut National de la Santé et de la Recherche Médicale - CNRS - Centre National de la Recherche Scientifique, HCL - Hospices Civils de Lyon
Giovanni Perricone: ASST Great Metropolitan Niguarda / ASST Grande Ospedale Metropolitano Niguarda [Milan, Italia]
Marina Berenguer: Hospital Universitari i Politècnic La Fe = University and Polytechnic Hospital La Fe
Lorenzo Mantovani: UNIMIB - Università degli Studi di Milano-Bicocca = University of Milano-Bicocca
Christophe Duvoux: Hôpital Henri Mondor
Luca Belli: ASST Great Metropolitan Niguarda / ASST Grande Ospedale Metropolitano Niguarda [Milan, Italia]

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Abstract: The European Liver and Intestine Transplant Association, ELITA, promoted a Consensus Conference involving 20 experts across the world which generated updated guidelines on HBV prophylaxis in liver transplant candidates and recipients. This study explores the economic impact associated with the implementation of the new ELITA guidelines. To this aim, a condition-specific cohort simulation model has been developed to compare new and historical prophylaxis, including only pharmaceutical cost and using the European perspective. The target population simulated in the model included both prevalent and incident cases, and consisted of 6,133 patients after the first year, that increased to 7,442 and 8,743 patents after 5 and 10 years from its implementation. The ELITA protocols allowed a cost saving of around € 235.65 million after 5 years and € 540.73 million after 10 years; which was mainly due to early HIBG withdrawal either after the first 4 weeks or after the first year post Liver Transplantation (LT) depending on the virological risk at transplantation. Results were confirmed by sensitivity analyses. The money saved by the implementation of the ELITA guidelines would allow healthcare decision makers and budget holders to understand where costs could be reduced and resources re-allocated to different needs.

Keywords: prophylaxis; hepatitis B; immunoglobulin (IgG); liver transplant; economics (search for similar items in EconPapers)
Date: 2023
New Economics Papers: this item is included in nep-hea
Note: View the original document on HAL open archive server: https://hal.science/hal-04165716v1
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Published in Transplant International, 2023, 36, pp.10954. ⟨10.3389/ti.2023.10954⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-04165716

DOI: 10.3389/ti.2023.10954

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