Screening for Hepatitis C in injecting drug users: a cost utility analysis

K. Stein, K. Dalziel, Anne Elizabeth Walker, B. Jenkins, A. Round, Pamela Lee Royle

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background Hepatitis C is a major public health problem of increasing importance among injecting drug users, among whom screening has been proposed. We therefore estimated the cost utility of screening for hepatitis C infection among people with a history of injecting drug use in contact with drug misuse services.

Methods A spreadsheet-based model of screening using ELISA followed by polymerase chain reaction tests and treatment using combination therapy with interferon alpha and ribavirin was developed. Parameters were informed by literature review, expert opinion and a survey of current screening practice in England. A range of one-way sensitivity analyses were carried out to explore uncertainty in the results for cost effectiveness.

Results Screening for HCV is likely to yield benefits in the population concerned at around pound28 000 per quality adjusted life year. This estimate is reasonably stable when explored in extensive one-way sensitivity analysis but appeared sensitive to the proportion of HCV positive people who accept biopsy or treatment and the utility gains associated with successful drug treatment. Important other areas of uncertainty include the effects of mortality from other causes on the cost effectiveness of screening in this population and the time at which symptoms would have led to presentation in the absence of a screening programme.

Conclusion Screening for HCV in this population is moderately cost effective, although some caution must remain in accepting this estimate given the current uncertainties in this field, and further research is required.

Original languageEnglish
Pages (from-to)61-71
Number of pages10
JournalJournal of Public Health Medicine
Volume26
Issue number1
DOIs
Publication statusPublished - Mar 2004

Keywords

  • screening
  • hepatitis C
  • drug users
  • cost utility
  • INTERFERON-ALPHA
  • VIRUS-INFECTION
  • LIVER-BIOPSY
  • RISK-FACTORS
  • RIBAVIRIN
  • COMBINATION
  • HCV
  • PROGRAM

Cite this

Stein, K., Dalziel, K., Walker, A. E., Jenkins, B., Round, A., & Royle, P. L. (2004). Screening for Hepatitis C in injecting drug users: a cost utility analysis. Journal of Public Health Medicine, 26(1), 61-71. https://doi.org/10.1093/pubmed/fdh109

Screening for Hepatitis C in injecting drug users: a cost utility analysis. / Stein, K.; Dalziel, K.; Walker, Anne Elizabeth; Jenkins, B.; Round, A.; Royle, Pamela Lee.

In: Journal of Public Health Medicine, Vol. 26, No. 1, 03.2004, p. 61-71.

Research output: Contribution to journalArticle

Stein, K, Dalziel, K, Walker, AE, Jenkins, B, Round, A & Royle, PL 2004, 'Screening for Hepatitis C in injecting drug users: a cost utility analysis', Journal of Public Health Medicine, vol. 26, no. 1, pp. 61-71. https://doi.org/10.1093/pubmed/fdh109
Stein, K. ; Dalziel, K. ; Walker, Anne Elizabeth ; Jenkins, B. ; Round, A. ; Royle, Pamela Lee. / Screening for Hepatitis C in injecting drug users: a cost utility analysis. In: Journal of Public Health Medicine. 2004 ; Vol. 26, No. 1. pp. 61-71.
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