The cost-effectiveness of one-time birth cohort hepatitis C screening as part of the NHS health check in England
PHE ePoster Library. Williams J. Sep 12, 2018; 221438; 194
Jack Williams
Jack Williams
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Abstract Introduction The prevalence of hepatitis C (HCV) in England is believed to be highest for those born between 1950 and 1979. Birth cohort screening for HCV has been implemented in the USA, but there is little evidence on the potential cost-effectiveness in England. The NHS offer a health check for adults aged 40-74 in England, which could provide a platform for HCV testing.MethodsA Markov model was developed to analyse one-time HCV testing added onto the NHS health check for birth cohorts born between 1950 and 1979. We assumed that the intervention costs were a HCV antibody test and additional nurse time (10 minutes). The model used data from a back-calculation model of the burden of HCV in England, sentinel surveillance of HCV testing, and from the literature. Costs are presented in 2016 GBP and outcomes as quality adjusted life years (QALYs).ResultsAt £20,000 per QALY, the probability of cost-effectiveness was low for those born from 1950-1959 (0-18.4%), borderline for those born from 1960-1964 (50.3%), and likely to be cost-effective for those born from 1964-1979 (72.5-83.9%). The model was most sensitive to the HCV disease state transition probabilities, the probability of treatment, and any additional cost of the intervention compared to current testing.ConclusionsBirth cohort screening for HCV may be cost-effective for some population groups as part of the NHS health check. However, further studies are required to assess the feasibility and reduce the uncertainty of the intervention itself, including potential costs not captured in this analysis.
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