Background and Aims: Cost-effective screening strategies are needed to make hepatitis C virus (HCV) elimination a reality. We determined if birth cohort screening is cost-effective in Italy. Methods: A model was developed to quantify screening and healthcare costs associated with HCV. The model-estimated prevalence of undiagnosed HCV was used to calculate the antibody screens needed annually, with a €25 000 cost-effectiveness threshold. Outcomes were assessed under the status quo and a scenario that met the World Health Organization's targets for elimination of HCV. The elimination scenario was assessed under five screening strategies. Results: A graduated birth cohort screening strategy (graduated screening 1: 1968-1987 birth cohorts, then expanding to 1948-1967 cohorts) was the least costly. This strategy would gain approximately 144 000 quality-adjusted life years (QALYs) by 2031 and result in an 89.3% reduction in HCV cases, compared to an 89.6%, 89.0%, 89.7% and 88.7% reduction for inversed graduated screening, 1948-77 birth cohort, 1958-77 birth cohort and universal screening, respectively. Graduated screening 1 yielded the lowest incremental cost-effectiveness ratio (ICER) of €3552 per QALY gained. Conclusions: In Italy, a graduated screening scenario is the most cost-effective strategy. Other countries could consider a similar birth cohort approach when developing HCV screening strategies.
Optimization of hepatitis C virus screening strategies by birth cohort in Italy / L.A. Kondili, I. Gamkrelidze, S. Blach, A. Marcellusi, M. Galli, S. Petta, M. Puoti, S. Vella, H. Razavi, A. Craxi, F.S. Mennini. - In: LIVER INTERNATIONAL. - ISSN 1478-3223. - 40:7(2020 Jul), pp. 1545-1555.
|Titolo:||Optimization of hepatitis C virus screening strategies by birth cohort in Italy|
|Parole Chiave:||cost-effectiveness; HCV; screening; WHO targets|
|Settore Scientifico Disciplinare:||Settore MED/17 - Malattie Infettive|
|Data di pubblicazione:||lug-2020|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1111/liv.14408|
|Appare nelle tipologie:||01 - Articolo su periodico|