Screening cost-effective to identify infected individuals born between 1945 and 1965
FRIDAY, Nov. 4 (HealthDay News) -- Birth cohort screening can be a cost-effective strategy to identify individuals infected with hepatitis C virus (HCV), according to a study published online Nov. 4 in the Annals of Internal Medicine.
David B. Rein, Ph.D., from the National Opinion Research Center at the University of Chicago in Atlanta, and colleagues examined whether birth cohort screening for HCV was cost-effective among adults born between 1945 and 1965. The participants of this birth cohort underwent one-time HCV antibody testing. Outcome measures included identifying, treating, and achieving sustained viral response in cases; liver disease and death from HCV; medical and productivity costs; quality-adjusted life years (QALY); and incremental cost-effectiveness ratio (ICER).
The investigators found that, compared to the current system, an additional 808,580 cases of chronic HCV were detected through birth cohort screening, with a screening cost of $2,874 per detected case. Based on an assumption that the screening was followed by pegylated interferon and ribavirin treatment, the QALYs increased by 348,800 due to the screening, and costs increased by $5.5 billion for an ICER of $15,700 per added QALY. However, based on an assumption that treated cases were given a direct acting antiviral, pegylated interferon, and ribavirin after screening, the QALYs increased by 532,200 due to the screening, and cost increased by $19.0 billion, for an ICER of $35,700 per added QALY. Sensitivity analysis showed that the birth cohort screening ICER was stable but most sensitive to the discount rate and the losses of QALY assigned to disease states.
"Birth cohort screening for HCV in primary care settings was highly cost-effective," the authors write.