Prevention of Hepatitis C by Screening and Treatment in U.S. Prisons
2016
This study assesses the health and economic impact of hepatitis C virus (HCV) screening and treatment in U.S. prisons on the broader HCV epidemic. Employing an agent-based microsimulation model of HCV transmission and disease progression, data from published literature inform the analysis. The target populations include individuals in U.S. prisons and the general community over a 30-year timeframe, adopting a societal perspective. Interventions encompass risk-based and universal opt-out HCV screening in prisons, followed by treatment for some patients. Key outcomes examined are the prevention of HCV transmission and associated disease, costs, quality-adjusted life-years (QALYs), incremental cost-effectiveness ratio (ICER), and total prison budget. Base-case analysis indicates that implementing screening could lead to significant reductions in new HCV cases and related deaths, with ICERs ranging from $19,600 to $29,200 per QALY. Sensitivity analysis underscores the robustness of findings, though limitations exist regarding data availability on transmission networks and screening rates. Universal opt-out HCV screening in prisons emerges as a highly cost-effective strategy to curb transmission and disease burden both within and beyond carceral settings, suggesting a strategic approach to tackling the current epidemic.
Prevention of Hepatitis C by Screening and Treatment in U.S. Prisons
Source:
He T, Li K, Roberts MS, Spaulding AC, Ayer T, Grefenstette JJ, Chhatwal J. Prevention of Hepatitis C by Screening and Treatment in U.S. Prisons. Annals of Internal Medicine 2016; 164: 84-92. https://doi.org/10.7326/m15-0617
Not open access.