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Is Adding HCV Screening to the Antenatal National Screening Program in Amsterdam, The Netherlands, Cost-Effective?

Author

Listed:
  • Anouk T Urbanus
  • Marjolijn van Keep
  • Amy A Matser
  • Mark H Rozenbaum
  • Christine J Weegink
  • Anneke van den Hoek
  • Maria Prins
  • Maarten J Postma

Abstract

Introduction: Hepatitis C virus (HCV) infection can lead to severe liver disease. Pregnant women are already routinely screened for several infectious diseases, but not yet for HCV infection. Here we examine whether adding HCV screening to routine screening is cost-effective. Methods: To estimate the cost-effectiveness of implementing HCV screening of all pregnant women and HCV screening of first-generation non-Western pregnant women as compared to no screening, we developed a Markov model. For the parameters of the model, we used prevalence data from pregnant women retrospectively tested for HCV in Amsterdam, the Netherlands, and from literature sources. In addition, we estimated the effect of possible treatment improvement in the future. Results: The incremental costs per woman screened was €41 and 0.0008 life-years were gained. The incremental cost-effectiveness ratio (ICER) was €52,473 which is above the cost-effectiveness threshold of €50,000. For screening first-generation non-Western migrants, the ICER was €47,113. Best-case analysis for both scenarios showed ICERs of respectively €19,505 and €17,533. We estimated that if costs per treatment were to decline to €3,750 (a reduction in price of €31,000), screening all pregnant women would be cost-effective. Conclusions: Currently, adding HCV screening to the already existing screening program for pregnant women is not cost-effective for women in general. However, adding HCV screening for first-generation non-Western women shows a modest cost-effective outcome. Yet, best case analysis shows potentials for an ICER below €20,000 per life-year gained. Treatment options will improve further in the coming years, enhancing cost-effectiveness even more.

Suggested Citation

  • Anouk T Urbanus & Marjolijn van Keep & Amy A Matser & Mark H Rozenbaum & Christine J Weegink & Anneke van den Hoek & Maria Prins & Maarten J Postma, 2013. "Is Adding HCV Screening to the Antenatal National Screening Program in Amsterdam, The Netherlands, Cost-Effective?," PLOS ONE, Public Library of Science, vol. 8(8), pages 1-9, August.
    • Handle: RePEc:plo:pone00:0070319
    DOI: 10.1371/journal.pone.0070319
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    Cited by:

    1. Claudia Geue & Olivia Wu & Yiqiao Xin & Robert Heggie & Sharon Hutchinson & Natasha K Martin & Elisabeth Fenwick & David Goldberg & Consortium and ECDC, 2015. "Cost-Effectiveness of HBV and HCV Screening Strategies – A Systematic Review of Existing Modelling Techniques," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-26, December.
    2. Bassem Asker & Raghad Jawad & Rabah Asreah & Haydar Jamal & Ahmed Jassem & Muslim Abdelkareem Inaya & Hiwa Abou Baker & Sam Kozma & Eid Mansour & Bryony McNamara & Ryan Miller & Oliver Darlington & Ph, 2021. "Cost Effectiveness of Screening for Hepatitis C Virus in Iraq in the Era of Simplified Testing and Treatment," PharmacoEconomics, Springer, vol. 39(11), pages 1327-1341, November.
    3. Job F. H. Eijsink & Mohamed N. M. T. Al Khayat & Cornelis Boersma & Peter G. J. Horst & Jan C. Wilschut & Maarten J. Postma, 2021. "Cost-effectiveness of hepatitis C virus screening, and subsequent monitoring or treatment among pregnant women in the Netherlands," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(1), pages 75-88, February.

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