title: Economic evaluation of screening programs for hepatitis C virus infection: evidence from literature.
abstract: BACKGROUND
  Hepatitis C is a liver infection caused by hepatitis C virus. Its main complications are cirrhosis and liver cancer. According to the World Health Organization (WHO), more than 185 million people worldwide are infected with hepatitis C virus and, of these, 350,000 die every year. Due to the high disease prevalence and the existence of effective (and expensive) medical treatments able to dramatically change the prognosis, early detection programs can potentially prevent the development of serious chronic conditions, improve health, and save resources.
  
  
  OBJECTIVE
  To summarize the available evidence on the cost-effectiveness of screening programs for hepatitis C.
  
  
  METHODS
  A literature search was performed on PubMed and Scopus search engines. Trip database was queried to identify reports produced by the major Health Technology Assessment (HTA) agencies. Three reviewers dealt with study selection and data extraction blindly.
  
  
  RESULTS
  Ten papers eventually met the inclusion criteria. In studies focusing on asymptomatic cohorts of individuals at general risk the cost/quality adjusted life year of screening programs ranged between US $4,200 and $50,000/quality adjusted life year gained, while in those focusing on specific risk factors the incremental cost-effectiveness ratio ranged between $848 and $128,424/quality adjusted life year gained. Age of the target population and disease prevalence were the main cost-effectiveness drivers.
  
  
  CONCLUSIONS
  Our results suggest that, especially in the long run, screening programs represent a cost-effective strategy for the management of hepatitis C.
authors.affiliation: Post-Graduate School of Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Coretti
authors.affiliation: Post-Graduate School of Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Romano
authors.affiliation: Center of Pharmacoeconomics (CIRFF), Department of Pharmacy, Federico II University, Naples, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Orlando
authors.affiliation: Post-Graduate School of Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Codella
authors.affiliation: Post-Graduate School of Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Prete
authors.affiliation: Post-Graduate School of Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Di Brino
authors.affiliation: Post-Graduate School of Economics and Management (ALTEMS), Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Ruggeri
keywords: cost-effectiveness; early detection; hepatitis C; screening