Economic evaluation of screening strategies for chronic hepatitis C

Objectives. - To evaluate the effectiveness, the costs and savings of hepatitis C screening strategies according to seroprevalence. Methods. - A decision analysis was performed to compare the cost and effectiveness between various screening strategies and the current strategy that implies no screening. Effectiveness was defined as the number of avoided pathologies as a result of screening. Benefits due to early screening and treatment were evaluated as avoided costs and were taking into account in the net costs. Two hypotheses were proposed for the treatment A disease history model was developed in order to evaluate the long term consequences of a screening programme (over a 10 year period). Results. - Status quo was dominated whatever screening strategies considered. The strategy consisting of an ELISA test confirmed by another ELISA was the best strategy in term of cost-effectiveness. Tb screen and to treat with interferon and ribavirine was a better option than adding ribavirine only for relapse patients. Conclusion. - To screen and treat infected HCV patients would be cost-savings if we compare with status quo. (C) 1999 Elsevier; Paris.