TY - JOUR
T1 - Cost-effectiveness of hepatitis C screening and treatment in low-income, primarily hispanic baby boomers
AU - Hollenbeak, Christopher S.
AU - Rochat, Andrea
AU - Hollenbeak, Asher C.
AU - Choi, Aro N.
AU - Gutierrez, Julio
AU - Turner, Barbara J.
N1 - Funding Information:
We would like to thank Steven Fox PhD of the Keck School of Medicine and the Schaeffer Center of the University of Southern California for his careful review of an earlier version of this manuscript.
Publisher Copyright:
© Meharry Medical College.
PY - 2019/8
Y1 - 2019/8
N2 - The cost- effectiveness of hepatitis C virus (HCV) screening and treatment was examined in low-income, primarily Hispanic baby boomers born 1945- 1965 using a Markov model of the natural history of HCV. The model was parameterized using costs and diagnostic data from 2008- 2016 and from literature on disease progression and effectiveness of screening and treatment using direct acting anti- viral (DAA) therapy. The incremental cost- effectiveness ratio (ICER) was computed from the perspective of Medicare as payer, calculated over 20 years, and discounted at 3% per year. In the base case, HCV screening cost $3,334 versus $3,797 for no screening, and yielded more quality- adjusted life years (QALYs; 14.08 vs 13.96, respectively). The ICER for screening was still less than $20,000 per additional QALY with drug costs up to $100,000. Among low-income Hispanics, HCV screening was less costly for Medicare and more effective than no screening under most assumptions. This analysis supports investment in screening and treatment in Hispanics.
AB - The cost- effectiveness of hepatitis C virus (HCV) screening and treatment was examined in low-income, primarily Hispanic baby boomers born 1945- 1965 using a Markov model of the natural history of HCV. The model was parameterized using costs and diagnostic data from 2008- 2016 and from literature on disease progression and effectiveness of screening and treatment using direct acting anti- viral (DAA) therapy. The incremental cost- effectiveness ratio (ICER) was computed from the perspective of Medicare as payer, calculated over 20 years, and discounted at 3% per year. In the base case, HCV screening cost $3,334 versus $3,797 for no screening, and yielded more quality- adjusted life years (QALYs; 14.08 vs 13.96, respectively). The ICER for screening was still less than $20,000 per additional QALY with drug costs up to $100,000. Among low-income Hispanics, HCV screening was less costly for Medicare and more effective than no screening under most assumptions. This analysis supports investment in screening and treatment in Hispanics.
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U2 - 10.1353/hpu.2019.0073
DO - 10.1353/hpu.2019.0073
M3 - Article
C2 - 31422988
AN - SCOPUS:85072144507
SN - 1049-2089
VL - 30
SP - 1053
EP - 1067
JO - Journal of Health Care for the Poor and Underserved
JF - Journal of Health Care for the Poor and Underserved
IS - 3
ER -
