Cost-effectiveness of chronic hepatitis C screening and treatment

Abstract

Hepatitis C virus (HCV) infection is the second most common cause of chronic liver disease in South Korea, with a prevalence ranging from 0.6% to 0.8%, and HCV infection incidence increases with age. The anti-HCV antibody test, which is cheaper than the HCV RNA assay, is widely used to screen for HCV infections; however, the underdiagnosis of HCV is a major barrier to the elimination of HCV infections. Although several risk factors have been associated with HCV infections, including intravenous drug use, blood transfusions, and hemodialysis, most patients with HCV infections present with no identifiable risk factors. Universal screening for HCV in adults has been suggested to improve the detection of HCV infections. We reviewed the cost-effectiveness of HCV screening and the methodologies used to perform screening. Recent studies have suggested that universal HCV screening and treatment using direct-acting antivirals represent cost-effective approaches to the prevention and treatment of HCV infection. However, the optimal timing and frequency of HCV screening remain unclear, and further studies are necessary to determine the best approaches for the elimination of HCV infections.

Keywords: Cost-effectiveness; Hepatitis C; Screening.

Figure 1.

The concept of cost-effectiveness analysis. Cost-effectiveness analyses simultaneously assess both costs and outcomes of an intervention and a comparator. Subscripted I refers to the intervention variables, whereas subscripted C refers to the comparator variables. Reused from Drummond et al. [22]