Neff Guy W, Duncan Christopher W, Schiff Eugene R
Dr. Neff is Chief of Hepatology at Tampa General Medical Group in Tampa, Florida. Dr. Duncan is affiliated with Highline Gastroenterology in Seattle, Washington. Dr. Schiff is a Professor of Medicine and Director of the Schiff Liver Institute and the Center for Liver Diseases at the University of Miami's Miller School of Medicine in Miami, Florida.
Gastroenterol Hepatol (N Y). 2011 Oct;7(10):661-71.
Cirrhosis is a worldwide problem that is associated with a substantial economic burden. Hepatitis B virus (HBV) infection, hepatitis C virus (HCV) infection, and alcoholic liver disease are the main causes of cirrhosis, but cost-effective preventive strategies are only available for HBV infection. Treatment algorithms for HBV infection and HCV infection are numerous and may be economically advantageous, depending on the regimen utilized; however, effective treatment for alcoholic liver disease is lacking, with abstinence from alcohol consumption continuing to be the main treatment strategy. In addition, liver transplantation (the only cure for cirrhosis) continues to consume substantial economic resources despite a recent reduction in overall cost. More sensitive predictors of post-liver transplantation disability could reduce this cost by allowing interventions that would promote productivity and increase health-related quality of life after liver transplantation. This paper highlights recent publications that evaluate the cost-effectiveness of strategies that prevent or treat the main causes of cirrhosis as well as publications that assess the impact of quality of life on the overall cost burden of the disease.
肝硬化是一个全球性问题,与之相关的经济负担沉重。乙型肝炎病毒(HBV)感染、丙型肝炎病毒(HCV)感染和酒精性肝病是肝硬化的主要病因,但目前仅针对HBV感染有具成本效益的预防策略。HBV感染和HCV感染的治疗方案众多,根据所采用的治疗方案,可能在经济上具有优势;然而,酒精性肝病缺乏有效的治疗方法,戒酒仍然是主要的治疗策略。此外,肝移植(肝硬化的唯一治愈方法)尽管近期总成本有所下降,但仍继续消耗大量经济资源。对肝移植后残疾更敏感的预测指标可以通过采取促进肝移植后生产力和提高健康相关生活质量的干预措施来降低这一成本。本文重点介绍了近期评估预防或治疗肝硬化主要病因策略的成本效益的出版物,以及评估生活质量对该疾病总体成本负担影响的出版物。