Economic evaluation of mass screening as a strategy for hepatitis C virus elimination in South Korea

Background: This study examines Hepatitis C virus (HCV) screening scenarios to meet World Health Organization (WHO) elimination targets (incidence ≤5 per 100,000, mortality ≤2 per 100,000) and assesses their timeframes and cost-effectiveness. Methods: A closed cohort model of Koreans aged 30–79 in 2...

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Main Authors: Hwa Young Choi, Kyung-Ah Kim, Bo Young Park, Bo Youl Choi, Moran Ki
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Journal of Infection and Public Health
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Online Access:http://www.sciencedirect.com/science/article/pii/S1876034125000115
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author Hwa Young Choi
Kyung-Ah Kim
Bo Young Park
Bo Youl Choi
Moran Ki
author_facet Hwa Young Choi
Kyung-Ah Kim
Bo Young Park
Bo Youl Choi
Moran Ki
author_sort Hwa Young Choi
collection DOAJ
description Background: This study examines Hepatitis C virus (HCV) screening scenarios to meet World Health Organization (WHO) elimination targets (incidence ≤5 per 100,000, mortality ≤2 per 100,000) and assesses their timeframes and cost-effectiveness. Methods: A closed cohort model of Koreans aged 30–79 in 2020 projected HCV incidence and mortality over 20 years. Economic evaluations used a dynamic transmission model, considering prevalent and annual incident cases. This approach addresses the limitations of previous models that neglected annual new HCV infections. Nine scenarios with varying screening intervals were created considering health checkup uptake, treatment rates, and HCV incidence reduction. Economic evaluations from the healthcare system's perspective employed cost-utility and cost-benefit analyses. Results: Without national HCV screening, incidence slightly decreases, whereas mortality triples over 20 years. Introducing HCV screening offers five scenarios to meet WHO targets in 20 years. The quickest, involving biennial screening, high uptake, and a 30% incidence reduction, meets the incidence target at 6 years and mortality target at 14 years. For the most cost-efficient scenario, screening every 4 years with moderate uptake and a 20% incidence reduction meets the incidence target at 17 years and mortality target at 18 years. The Incremental Cost-Effectiveness Ratio (ICER) is $8,867 per quality-adjusted life-year (QALY), with a Benefit-Cost Ratio (BCR) of 1.60. Conclusion: The absence of HCV screening impedes elimination goals and increases mortality. Biennial screening, with high participation and treatment rates, rapidly achieves targets but is less economically efficient. Screening every 4 years with moderate uptake and treatment rates is economically feasible and meets elimination goals within 20 years. Rapid screening implementation is crucial for effective HCV elimination.
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spelling doaj-art-9e32b0bac33244fdbe9d0826afdde1022025-08-20T02:14:56ZengElsevierJournal of Infection and Public Health1876-03412025-03-0118310266210.1016/j.jiph.2025.102662Economic evaluation of mass screening as a strategy for hepatitis C virus elimination in South KoreaHwa Young Choi0Kyung-Ah Kim1Bo Young Park2Bo Youl Choi3Moran Ki4Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of KoreaDepartment of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of KoreaDepartment of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of KoreaDepartment of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of KoreaDepartment of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea; Correspondence to: Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang, Gyeonggi-do 410-769, Republic of Korea.Background: This study examines Hepatitis C virus (HCV) screening scenarios to meet World Health Organization (WHO) elimination targets (incidence ≤5 per 100,000, mortality ≤2 per 100,000) and assesses their timeframes and cost-effectiveness. Methods: A closed cohort model of Koreans aged 30–79 in 2020 projected HCV incidence and mortality over 20 years. Economic evaluations used a dynamic transmission model, considering prevalent and annual incident cases. This approach addresses the limitations of previous models that neglected annual new HCV infections. Nine scenarios with varying screening intervals were created considering health checkup uptake, treatment rates, and HCV incidence reduction. Economic evaluations from the healthcare system's perspective employed cost-utility and cost-benefit analyses. Results: Without national HCV screening, incidence slightly decreases, whereas mortality triples over 20 years. Introducing HCV screening offers five scenarios to meet WHO targets in 20 years. The quickest, involving biennial screening, high uptake, and a 30% incidence reduction, meets the incidence target at 6 years and mortality target at 14 years. For the most cost-efficient scenario, screening every 4 years with moderate uptake and a 20% incidence reduction meets the incidence target at 17 years and mortality target at 18 years. The Incremental Cost-Effectiveness Ratio (ICER) is $8,867 per quality-adjusted life-year (QALY), with a Benefit-Cost Ratio (BCR) of 1.60. Conclusion: The absence of HCV screening impedes elimination goals and increases mortality. Biennial screening, with high participation and treatment rates, rapidly achieves targets but is less economically efficient. Screening every 4 years with moderate uptake and treatment rates is economically feasible and meets elimination goals within 20 years. Rapid screening implementation is crucial for effective HCV elimination.http://www.sciencedirect.com/science/article/pii/S1876034125000115Hepatitis CWorld Health Organization Hepatitis C elimination targetMass screeningDynamic transmission modelEconomic evaluation
spellingShingle Hwa Young Choi
Kyung-Ah Kim
Bo Young Park
Bo Youl Choi
Moran Ki
Economic evaluation of mass screening as a strategy for hepatitis C virus elimination in South Korea
Journal of Infection and Public Health
Hepatitis C
World Health Organization Hepatitis C elimination target
Mass screening
Dynamic transmission model
Economic evaluation
title Economic evaluation of mass screening as a strategy for hepatitis C virus elimination in South Korea
title_full Economic evaluation of mass screening as a strategy for hepatitis C virus elimination in South Korea
title_fullStr Economic evaluation of mass screening as a strategy for hepatitis C virus elimination in South Korea
title_full_unstemmed Economic evaluation of mass screening as a strategy for hepatitis C virus elimination in South Korea
title_short Economic evaluation of mass screening as a strategy for hepatitis C virus elimination in South Korea
title_sort economic evaluation of mass screening as a strategy for hepatitis c virus elimination in south korea
topic Hepatitis C
World Health Organization Hepatitis C elimination target
Mass screening
Dynamic transmission model
Economic evaluation
url http://www.sciencedirect.com/science/article/pii/S1876034125000115
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