Economic consequences of the implementation of national screening program for chronic HCV infection

Chronic HCV infection is still one of the leading causes for liver morbidity and mortality worldwide. Increase in testing and diagnosis would result in early identification of people with chronic infection and would enable timely access to care and treatment, as well as prevent or delay progression of liver disease. The aim of the present study is to examine the cost and benefits of introducing ones per life testing for HCV infection among the group of 39-64 years old people who regularly go to prophylactic examinations in Bulgaria.

Combined cost-effectiveness and cost-benefit analysis was performed to evaluate the cost-effectiveness and net benefit of three screening approaches.

Screening of the birth-cohort type (aged 39-64 and born before the blood testing became available) provides benefits compared to the current practice of symptomatic testing and leads to more LYGs. Testing among this age group is efficient with an ICER below the proposed by WHO threshold of 1-3 times GDP/capita.

Targeted testing among adults between 39 and 64 years with anti-HCV antibody once per their life in Bulgaria could be considered as cost-effective and provides benefits both for the paying institutions and the patients.