The costs and impacts of testing for hepatitis C virus antibody in public STD clinics.
OBJECTIVE
To estimate the cost and cost-effectiveness of testing sexually transmitted disease (STD) clinic subgroups for antibodies to hepatitis C virus (HCV).


METHODS
HCV counseling, testing, and referral (CTR) costs were estimated using data from two STD clinics and the literature, and are reported in 2006 dollars. Effectiveness of HCV CTR was defined as the estimated percentage of clinic clients in subgroups targeted for HCV antibody (anti-HCV) testing who had a true positive test and returned for their test results. We estimated the cost per true positive injection drug user (IDU) who returned for anti-HCV test results and the cost-effectiveness of expanding HCV CTR to non-IDU subgroups.


RESULTS
The estimated cost per true positive IDU who returned for test results was $54. The cost-effectiveness of expanding HCV CTR to non-IDU subgroups ranged from $179 to $2,986. Our estimates were most sensitive to variations in HCV prevalence, the cost of testing, and the rate of client return.


CONCLUSIONS
Based on national data, testing IDUs in the STD clinic setting is highly cost-effective. Some clinics may find that it is cost-effective to expand testing to non-IDU men older than 40 who report more than 100 lifetime sex partners. STD clinics can use study estimates to assess the feasibility and desirability of expanding HCV CTR beyond IDUs.
Honeycutt
Amanda A
AA
RTI International, Research Triangle Park, NC, USA. honeycutt@rti.org
Harris
Jennie L
JL
Khavjou
Olga
O
Buffington
Joanna
J
Jones
T Stephen
TS
Rein
David B
DB
D000554:Ambulatory Care Facilities / Q000191:economics* / Q000458:organization & administration; D003365:Costs and Cost Analysis; D006526:Hepatitis C / Q000150:complications / Q000175:diagnosis* / Q000191:economics*; D018937:Hepatitis C Antibodies / Q000097:blood*; D006801:Humans; D010353:Patient Education as Topic / Q000458:organization & administration; D015980:Public Health Practice / Q000191:economics; D012017:Referral and Consultation / Q000458:organization & administration; D012749:Sexually Transmitted Diseases / Q000150:complications / Q000175:diagnosis / Q000628:therapy*
D018937:Hepatitis C Antibodies