부산대학교 도서관

Background & Aims: Hepatitis C virus (HCV) continues to pose significant public health concerns with approximately 44% of chronically infected Canadians undiagnosed. The current HCV screening in Canada is a two‐step diagnosis pathway consisting of anti‐HCV testing and HCV ribonucleic acid (RNA) testing. The introduction of HCV point‐of‐care assays, such as the Xpert HCV viral load finger‐stick assay, can facilitate HCV RNA diagnosis during a single visit and provide quick linkage to care. We evaluated the cost‐effectiveness of HCV point‐of‐care testing compared with current HCV screening strategies for injection drug users (IDUs) from a Canadian provincial Ministry of Health perspective. Methods: A state‐transition model based on published literature was developed to compare HCV point‐of‐care assay with the standard‐of‐care blood screening for a one‐time HCV screening and treatment program. It adopted a lifetime time horizon and included health states related to treatment, fibrosis stages, and advanced liver disease clinical states. Outcomes were expressed in costs, quality‐adjusted life years (QALYs), and incremental cost‐effectiveness ratios. Sensitivity analyses were conducted to assess the robustness of the model. Results: HCV point‐of‐care assay generated an additional 0.035 QALYs/person at a cost reduction of $21.15 compared with the standard‐of‐care screening. The results were the most sensitive to the specificity of HCV point‐of‐care assay. Conclusions: The implementation of HCV point‐of‐care screening in Canada is likely to be cost‐saving for IDUs. Early detection and treatment of undiagnosed individuals can prolong people's life span and save healthcare costs associated with HCV‐related complications. [ABSTRACT FROM AUTHOR]