Asia-Pacific region - Cost-effectiveness prevention and management of gastrointestinal and liver disease

Review Article
COST-EFFECTIVE OPTIONS FOR THE PREVENTION AND MANAGEMENT OF GASTROINTESTINAL AND LIVER DISEASE IN THE ASIA-PACIFIC REGION
Authors Ian C Roberts-Thomson, Thomas Lung
Accepted manuscript online: 17 August 2017
Full publication history DOI: 10.1111/jgh.13925 

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Abstract
The Asia-Pacific region contains more than half of the world's population and is markedly heterogeneous in relation to income levels and the provision of public and private health services. For low-income countries, the major health priorities are child and maternal health. In contrast, priorities for high-income countries include vascular disease, cancer, diabetes, dementia and mental health disorders as well as chronic inflammatory disorders such as hepatitis B and hepatitis C. Cost-effectiveness analyses are methods for assessing the gains in health relative to the costs of different health interventions. Methods for measuring health outcomes include years of life saved [or lost], quality-adjusted life years [QALYs] and disability-adjusted life years [DALYs]. The incremental cost-effectiveness ratio [ICER] measures the cost [usually in US dollars] per life year saved, QALY gained or DALY averted of one intervention relative to another. In low-income countries, approximately 50% of infant deaths [<5years] are caused by gastroenteritis, the major pathogen being rotavirus infection. Rotavirus vaccines appear to be cost-effective but, thus far, have not been widely adopted. In contrast, infant vaccination for hepatitis B is promoted in most countries with a striking reduction in the prevalence of infection in vaccinated individuals. Cost-effectiveness analyses have also been applied to newer and more expensive drugs for hepatitis B and C and to government-sponsored programs for the early detection of hepatocellular, gastric and colorectal cancer. Most of these studies reveal that newer drugs and surveillance programs for cancer are only marginally cost-effective in the setting of a high-income country.

Source - Journal of Gastroenterology and Hepatology