The wider public health value of HCV treatment accrued by liver transplant recipients.
OBJECTIVE
Organs for transplantation are scarce, but new medical therapies can prevent organ failure and the need for transplants. We sought to describe the unique value created by treatments that spare organs from failure and thus conserve donated organs for transplant into others, using hepatitis C virus (HCV) as a case study.


METHODS
Epidemiologic-economic model.


METHODS
Using data on trends in chronic liver disease, liver disease progression, and liver transplant allocation models, as well as the effectiveness of new HCV treatments, we estimate the potential effects of systematic HCV screening and treatment on the demand for liver transplants in the United States. We estimate the spillover benefits to patients with all-cause liver disease in terms of increased availability of transplants and life-years gained.


RESULTS
We estimated that systematic HCV screening and treatment could spare 10,490 liver transplants to HCV-infected patients from 2015 to 2035. An estimated 7321 transplants would accrue to patients with end-stage liver disease without HCV and 3169 transplants to those with uncured HCV, providing approximately 52,700 and 22,800 additional life-years, respectively.


CONCLUSIONS
Treatment advances for HCV have the potential to generate considerable spillover benefits to patients awaiting transplants for non-HCV-mediated liver failure. For other diseases in which organ transplants are in short supply, our study provides a novel pathway by which positive spillovers may accrue from treatments that prevent end-stage organ disease.
Harvard Medical School, Department of Health Care Policy, 180 Longwood Ave, Boston, MA 02115. E-mail: jena@hcp.med.harvard.edu.
Anupam B
AB
Jena
Warren
W
Stevens
Yuri Sanchez
YS
Gonzalez
Steven E
SE
Marx
Timothy
T
Juday
Darius N
DN
Lakdawalla
Tomas J
TJ
Philipson
D002487:Centers for Disease Control and Prevention, U.S. / Q000706:statistics & numerical data; D042241:Early Diagnosis; D058625:End Stage Liver Disease / Q000191:economics* / Q000209:etiology / Q000517:prevention & control / Q000601:surgery; D019698:Hepatitis C, Chronic / Q000150:complications / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation / Q000191:economics* / Q000706:statistics & numerical data; D008390:Markov Chains; D018803:Models, Economic; D009010:Monte Carlo Method; D009749:Nutrition Surveys / Q000706:statistics & numerical data; D015995:Prevalence; D014481:United States / Q000453:epidemiology