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The European Journal of Public Health 2001 11(4):373-379; doi:10.1093/eurpub/11.4.373
© 2001 by European Journal of Public Health
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HEALTH ECONOMICS

Cost-effectiveness analysis of strategies for hepatitis C screening in French blood recipients

J.F. JUSOT1, and C. COLIN1

1Medical Evaluation Unit, Département d'Information Médicale des Hospices Civils de Lyon Lyon, France

Doctor J.F Jusot, Medical Evaluation Unit, Département d'Information Médicale, 162 Avenue Lacassagne, 69003 Lyon, France, tel. +33 4 72115771, fax +33 4 72115720, e-mail JFJusot{at}wanadoo.fr

Background: In a context of scarce health resources and varied medical practices, the aim of this study was to compare cost-effectiveness of different screening strategies for hepatitis C virus among blood recipients. Methods: A cost-effectiveness model was used to test nine screening strategies in three survival categories. Three Markov models were used for three methods of follow-up. The marginal cost-effectiveness ratio was estimated to compare the screening strategies. Results: Hepatitis C virus serology by enzyme-linked immunosorbent assay and confirmation by detection of the virus RNA was proved to be the dominant strategy. The marginal cost-effectiveness ratios were for subjects under 40 and low-volume transfusion patients, 776, 474 and 2, 636, 500 French Francs-1996 (about USD 111, 000 and 376, 650) per life-year gained, respectively. Sensitivity analysis showed that the marginal cost-effectiveness ratio was influenced by the prevalence and the survival rates. The lower marginal cost-effectiveness ratio was estimated at 690, 221 French Francs-1996 per life-year gained. Conclusion: This study showed high costs and few life-years gained for the dominant strategy even for the more favourable risk group. New studies may be carried out for new screening and therapeutic strategies.

Keywords: blood, cost-effectiveness, hepatitis C, mass screening, transfusion


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