Background: currently, 123-170 million people in the world are infected with Hepatitis C Virus (HCV) and 75% of them remain undiagnosed. HCV-positive individuals will develop Chronic Hepatitis C (CHC) or hepatocellular carcinoma (HCC) within 25 years in 20-30% of cases. Early detection of HCV has been demonstrated to increase quality-adjusted life years (QALY) and to improve the behaviour of the infected population. Current national policies usually recommend regular screenings only for at-risk populations. A systematic review of the recent evidence on long-term cost-effectiveness of HCV screening in different populations was performed. Methods: resources were searched on publicly available databases (PubMed, ScienceDirect, NHS EED, Cochrane Library) and Google®. Studies were considered eligible if published between 2007 and 2012 and if providing measures of incremental cost-effectiveness ratio (ICER) or incremental cost utility ratio (ICUR) of HCV screening in terms of cost/life years gained (LYG) and cost/QALY. All the costs were converted into Euro (€) for 2011. A weighted version of the Drummond checklist was used to further assess the quality of the included studies. Results: six articles were selected and analysed. Three U.S. and one Japanese studies suggested a positive cost-effectiveness profile of broad birth-cohort and population screening. Other studies conducted in Italy and the UK demonstrated high variability in the cost-effectiveness in different study populations. All the studies were judged of medium-high quality. ConclusionS: cost-effectiveness of HCV screening significantly varies among countries and study populations. Prevalence in the population should be one of the criteria for policy-makers for future decisions and recommendations. New Direct-Acting Antiviral agents might increase the costeffectiveness of early HCV screening. Future studies should also focus on migrants and men who have sex with men (MSM) populations.
Camera, A., Ianuale, C., Boccia, S., Cost-effectiveness of HCV screening: A systematic review of the literature from 2007 to 2012, <<EPIDEMIOLOGY BIOSTATISTICS AND PUBLIC HEALTH>>, 2013; (Settembre): pe8767-1-pe8767-8. [doi:10.2427/8767] [http://hdl.handle.net/10807/51921]
Cost-effectiveness of HCV screening: A systematic review of the literature from 2007 to 2012
Ianuale, Carolina;Boccia, Stefania
2013
Abstract
Background: currently, 123-170 million people in the world are infected with Hepatitis C Virus (HCV) and 75% of them remain undiagnosed. HCV-positive individuals will develop Chronic Hepatitis C (CHC) or hepatocellular carcinoma (HCC) within 25 years in 20-30% of cases. Early detection of HCV has been demonstrated to increase quality-adjusted life years (QALY) and to improve the behaviour of the infected population. Current national policies usually recommend regular screenings only for at-risk populations. A systematic review of the recent evidence on long-term cost-effectiveness of HCV screening in different populations was performed. Methods: resources were searched on publicly available databases (PubMed, ScienceDirect, NHS EED, Cochrane Library) and Google®. Studies were considered eligible if published between 2007 and 2012 and if providing measures of incremental cost-effectiveness ratio (ICER) or incremental cost utility ratio (ICUR) of HCV screening in terms of cost/life years gained (LYG) and cost/QALY. All the costs were converted into Euro (€) for 2011. A weighted version of the Drummond checklist was used to further assess the quality of the included studies. Results: six articles were selected and analysed. Three U.S. and one Japanese studies suggested a positive cost-effectiveness profile of broad birth-cohort and population screening. Other studies conducted in Italy and the UK demonstrated high variability in the cost-effectiveness in different study populations. All the studies were judged of medium-high quality. ConclusionS: cost-effectiveness of HCV screening significantly varies among countries and study populations. Prevalence in the population should be one of the criteria for policy-makers for future decisions and recommendations. New Direct-Acting Antiviral agents might increase the costeffectiveness of early HCV screening. Future studies should also focus on migrants and men who have sex with men (MSM) populations.
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