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. 2015 Dec 21;10(12):e0145022.
doi: 10.1371/journal.pone.0145022. eCollection 2015.

Cost-Effectiveness of HBV and HCV Screening Strategies--A Systematic Review of Existing Modelling Techniques

Claudia Geue  1 , Olivia Wu  1 , Yiqiao Xin  1 , Robert Heggie  1 , Sharon Hutchinson  2 , Natasha K Martin  3   4 , Elisabeth Fenwick  5 , David Goldberg  6 ; Consortium; ECDC
Collaborators, Affiliations

Cost-Effectiveness of HBV and HCV Screening Strategies--A Systematic Review of Existing Modelling Techniques

Claudia Geue et al. PLoS One. .

Abstract

Introduction: Studies evaluating the cost-effectiveness of screening for Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) are generally heterogeneous in terms of risk groups, settings, screening intervention, outcomes and the economic modelling framework. It is therefore difficult to compare cost-effectiveness results between studies. This systematic review aims to summarise and critically assess existing economic models for HBV and HCV in order to identify the main methodological differences in modelling approaches.

Methods: A structured search strategy was developed and a systematic review carried out. A critical assessment of the decision-analytic models was carried out according to the guidelines and framework developed for assessment of decision-analytic models in Health Technology Assessment of health care interventions.

Results: The overall approach to analysing the cost-effectiveness of screening strategies was found to be broadly consistent for HBV and HCV. However, modelling parameters and related structure differed between models, producing different results. More recent publications performed better against a performance matrix, evaluating model components and methodology.

Conclusion: When assessing screening strategies for HBV and HCV infection, the focus should be on more recent studies, which applied the latest treatment regimes, test methods and had better and more complete data on which to base their models. In addition to parameter selection and associated assumptions, careful consideration of dynamic versus static modelling is recommended. Future research may want to focus on these methodological issues. In addition, the ability to evaluate screening strategies for multiple infectious diseases, (HCV and HIV at the same time) might prove important for decision makers.

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Conflict of interest statement

Competing Interests: EF declares current commercial affiliation, however this was not the case at the time the study was undertaken. NKM has received research grants from Gilead unrelated to this work and has received honoria from AbbVie. This does not alter the authors' adherence to all PLOS ONE policies on sharing data and materials. The authors declare that no competing interests exist.

Figures

Fig 1
Fig 1. Selection of studies on cost-effectiveness of HBV screening until November 2011.
Fig 2
Fig 2. Selection of studies on cost-effectiveness of HBV screening; September 2011 until July 2015.
Fig 3
Fig 3. Performance Matrix—HBV screening models.
Fig 4
Fig 4. Selection of studies on cost-effectiveness of HCV screening until November 2011.
Fig 5
Fig 5. Selection of studies on cost-effectiveness of HCV screening; September 2011 until July 2015.
Fig 6
Fig 6. Performance Matrix—HCV screening models.
See this image and copyright information in PMC

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