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Title: The application of health technology assessment in Egypt : case study using hepatitis C
Author: Elbatran, May Mohamed
Awarding Body: Swansea University
Current Institution: Swansea University
Date of Award: 2008
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The application of health technology assessment in Egypt: case study using hepatitis C The staggering prevalence of Chronic hepatitis C virus (HCV) infection in Egypt ranging from 15-20% places tremendous demands on the health care system and the society. This fact made it a good example to use to measure the feasibility of pharmacoeconomic and health assessment research in Egypt. The study attempted to answer some of the questions that policy makers and physicians need to address and patients need to consider when undertaking treatment of HCV infection. A critical appraisal was also included to confront and to highlight some additional issues that need be addressed, amended and/or altered when undertaking treatment decisions regarding HCV. In this study, cost of the disease was calculated as well as the cost effectiveness of the various treatment options available: the supportive treatment pathway and both standard interferon and pegylated interferon combination treatment pathways. Outpatients and inpatients with chronic hepatitis C liver cirrhosis frequenting the National Liver Institute, Menoufia, Egypt's largest and busiest public tertiary referral government health subsidized center. The mean annual cost per patient was assessed and the data computed using computer cohorts of 100 patients following the Markov models of the natural history of disease progression. It was found that the cost of pegylated interferon combination therapy over the full cycle of the disease was the most cost effective alternative amounting to 75 704.61 LE versus 144 872.23LE and 92 155.61LE for the supportive and the standard interferon treatment pathways respectively and thus its cost effectiveness values were negative compared to the other pathways. The same results were true for patients visiting private profit and non profit medical settings. This in turn helps to emphasize the importance of adopting health economic evaluations in the determination of efficiency of the health care services and policies in Egypt. It was concluded that it was more cost effective to use antiviral therapy in relation to the cheaper supportive option where not only cost effectiveness ratio was negative for both the regular interferon and the pegylated interferon alternatives but also 10% and 14% of lives were saved respectively. The study proves the feasibility and the importance of implementing health economics and health technology assessment studies towards health improvement in Egypt. It further highlights that informed decision makers can have a positive effect on the health budget and consequently on unwritten social contract and ethical guidelines they have with their communities and society at large.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available