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Related Experiment Videos

Case finding for hepatitis C in primary care: a cost utility analysis.

Joanna Thompson Coon1, Emanuela Castelnuovo, Martin Pitt

  • 1Peninsula Technology Assessment Group, Peninsula Medical School, University of Exeter, Noy Scott House, Barrack Road, Exeter, EX2 5DW, UK. Joanna.Thompson-Coon@pentag.nhs.uk

Family Practice
|June 27, 2006
PubMed
Summary

Identifying hepatitis C (HCV) in primary care among former injecting drug users (IDUs) appears cost-effective. This proactive case finding offers a high probability of being cost-effective, though further research is recommended.

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Area of Science:

  • Public Health
  • Health Economics
  • Infectious Disease Epidemiology

Background:

  • Hepatitis C (HCV) presents a significant public health challenge requiring intensified efforts for case identification.
  • Primary care settings are crucial for implementing effective HCV case-finding strategies.
  • Former injecting drug users (IDUs) are a key population for targeted HCV screening.

Purpose of the Study:

  • To conduct a cost-utility analysis of systematic hepatitis C case finding within primary care settings.
  • To specifically evaluate this strategy among a cohort of former injecting drug users (IDUs).

Main Methods:

  • A Markov model simulated the impact of HCV case finding and treatment on disease progression in 1000 former IDUs.
  • Compared systematic case finding with a control group allowing spontaneous testing.

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  • Utilized ELISA and PCR tests, with eligible patients receiving combination therapy (pegylated interferon and ribavirin).

    • Main Results:

    • Cost utility was estimated at approximately £16,000 per QALY for both case-finding and spontaneous presentation scenarios.
    • A 75% probability of cost-effectiveness was observed at a willingness-to-pay threshold of £30,000 per QALY.
    • Uncertainties identified include utility data, discounting, and spontaneous re-presentation rates.

    Conclusions:

    • HCV case finding in primary care is likely cost-effective, despite existing uncertainties.
    • Further research is necessary to explore and refine various primary care-based case-finding approaches.