A cost-effectiveness analysis of the use of safety-engineered syringes in reducing HBV, HCV, and HIV burden in Egypt

ABSTRACT

Introduction: The objective of this study was to estimate the effects and costs of safety-engineered syringes (SS) as a prevention strategy from HBV, HCV, and HIV infections versus conventional syringes (CS).

Methods: A decision-analytic model with five health states was constructed. The clinical parameters and utilities were derived using published data. Direct medical costs from the health care system perspective were sourced from national data. All costs and effects were discounted at 3.5% annually.

Results: The estimate of total quality adjusted life years (QALYs) while using SS were 10.87 compared to 9.20 for the use of CS in the Egyptian population exposed to unsafe injection practices. The total costs for using SS and CS were EGP2,870 and EGP81,794 (I$1,130 and I$32,202), respectively, per 5.9 injections per person per year. Adopting SS resulted in better outcomes (difference; 1.66 QALYs) and total savings (EGP-78,924/I$-31,073) per person.

Conclusion: Introducing SS in the Egyptian health care system might help in preventing transmission of blood-borne infections that are acquired through health care settings. The overall benefit of investing in this technology is far more than CS. These findings encourage the urgent adoption of SS by health care delivery institutions in similar resource-limited settings.

KEYWORDS:

• Cost-effectiveness
• safety-engineered syringes
• Egypt
• HCV

Acknowledgments

We would like to thank John Jabbour, WHO Representative for Egypt for supporting this work and Alaa Hashish, Medical Officer, Communicable Diseases, World Health Organization, Country Office, Egypt for his technical support from its beginning till its completion. We also thank all the professionals who provided estimates of national data for this study: Manal Hamdy Elsayed, Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo Egypt. Emam Waked, Professor of Hepatology, National Liver Institute, Menoufiya, Egypt. Waleed Kamal, National AIDS Program, Egyptian Ministry of Health and Population. Ashraf Eletreby, Fever Hospital directorate, MoHP, Cairo, Egypt. Shaymaa Shawky, Central Laboratories, Egyptian Ministry of Health and Population.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was funded through the World Health Organization, Country Office in Egypt [2017/704107-0].