Cost Effectiveness of Implementing a Screening and Treatment Program for Hepatitis C Virus Infection in Egypt
AUTHORS: DD Kim, DW Hutton, AA Raouf, M Salama, A Hablas, IA Seifeldin, AS Soliman
Egypt has one of the highest prevalence of hepatitis C virus (HCV) infection in the World. We estimated the cost-effectiveness of implementing a screening and treatment program for HCV infection among Egyptians.
We developed a Markov decision analysis model of the natural history of HCV infection and treatment to evaluate the cost-effectiveness of a screening and treatment program for asymptomatic, average-risk Egyptian adults. We used hepatitis C age-specific disease progression rates and prevalence for Egyptians. Lifetime costs related to screening, treatment, disease progression and health utilities have been used with 3% annual discounting. We used a societal perspective, local cost estimates in Egypt, quality-adjusted life years (QALYs) gained, and calculated the incremental cost-effectiveness ratio of a hypothetical program of screening and treating Egyptians for HCV versus no screening. Sensitivity analysis was conducted to test uncertainty in the model assumptions.
Under base case assumptions, implementing a screening and treatment program for a 40-year-old, asymptomatic Egyptian adult would cost $1,856 for 19.192 QALYs, while non-screening would cost $1,807 for 19.164 QALYs for the 40 year time horizon. The incremental cost-effectiveness ratio (ICER) is $1,750/QALY (equivalent to about 10,392 LE, Egyptian pound/QALY). If applied to the entire population of 10 to 60 year-olds in Egypt, this program would lead to long-term costs of 2.15 billion dollars, but would save one million life years. Results were the most sensitive to change in disutility by being identified as HCV-positive after screening, as well as probability of receiving treatment after HCV positive diagnosis and probability of successful treatment.
Comparing this model to international standards for cost-effectiveness, implementing a screening and treatment program for HCV in Egypt would be considered very cost-effective. Therefore, we recommend implementing HCV screening and treatment programs to reduce the burden of liver disease in Egypt.
- Graduate Programs
CEESP Project Timeline
- How to Apply
- International Internships 2013
- Domestic Internships 2013
- Summer 2012
- Summer 2011
- Summer 2010
- Summer 2009
- Summer 2008
- Summer 2007
- Summer 2006
- Affiliated Students