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Research finds targeted screening for hepatitis C is cost-effective
Date:4/24/2013

examine screening in a U.S. community whose residents showed no symptoms.

"The base case was an ethnically and gender-mixed adult population with no prior knowledge of diagnosis: 49 percent male, 78 percent white, 13 percent black and 9 percent Hispanic, with a mean age of 46 years," says Eckman.

The model explored strategies of screening followed by guideline-based treatment, if needed, and not screening. Effectiveness was measured in quality-adjusted life years (QALYs)accounting for both duration of survival and quality of lifeand costs were measured in U.S. dollars.

"In the base case, screening followed by guideline-based treatmentusing boceprevir as the standard antiviral treatmentof those with chronic hepatitis C infection cost roughly $47,000 per QALYa 'cost-effective' result," says Eckman. "The overall hepatitis C prevalence in the U.S. is reported to be between 1.3 and 1.9 percent, but prevalence varies among patients with different risk factors."

He continues that the marginal cost-effectiveness ratio (mCER) of screening decreases as prevalence increases.

"Below a prevalence of 0.84 percent within a population, the mCER is greater than the generally accepted societal willingness-to-pay threshold of $50,000 per QALY," he says. "Therefore, it is not considered highly cost-effective. However, by targeting screening in populations with a higher estimated prevalence, screening and subsequent treatment of those infected would be cost effective."

"Recently released guidelines by the Centers for Disease Control and Prevention advocate 'birth-cohort' focused screening for those born between 1945 and 1965. However, such a strategy may miss screening higher risk patients born in years outside of this cohort," Eckman adds. "Alternatively, patients with no risk factors for hepatitis C infection, other than their membership in the 'birth cohort,' may be at a low enough risk to make their screening less cost-effective.
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Contact: Katie Pence
katie.pence@uc.edu
513-558-4561
University of Cincinnati Academic Health Center
Source:Eurekalert

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