Routine hepatitis C virus screening in pregnancy: a cost-effectiveness analysis

Area of Science:

• Hepatology
• Public Health
• Health Economics

Background:

• Hepatitis C virus (HCV) infection poses risks during pregnancy.
• Effective screening and treatment strategies are crucial for maternal and child health.
• The cost-effectiveness of routine HCV screening in pregnant populations remains under investigation.

Purpose of the Study:

• To evaluate the cost-effectiveness of routine hepatitis C virus (HCV) screening in pregnant women.
• To compare three management strategies for asymptomatic HCV infection in low-risk pregnant women.

Main Methods:

• A decision tree model with Markov analysis was employed.
• Three scenarios were compared: no screening, screening with treatment for progressive disease, and screening with treatment plus elective cesarean delivery.
• Lifetime costs and quality-adjusted life years (QALYs) for mother and child were assessed.

Main Results:

• HCV screening and treatment of progressive disease was dominated by no screening (higher cost, lower effectiveness).
• Screening, treatment, and cesarean delivery yielded an incremental cost of $117 and a decreased effectiveness of 0.00010 QALYs per mother-child pair.
• The cost-effectiveness ratio for screening, treatment, and cesarean delivery was $1,170,000 per QALY.

Conclusions:

• Routine screening for hepatitis C virus infection in asymptomatic pregnant women is not a cost-effective strategy.
• Current screening and treatment protocols for HCV in pregnancy do not demonstrate favorable economic value.
• Further research may be needed to identify cost-effective screening approaches for HCV in pregnant populations.