title: Estimating the Cost-Effectiveness of One-Time Screening and Treatment for Hepatitis C in Korea.
abstract: This study aims to investigate the cost-effectiveness of a one-time hepatitis C virus (HCV) screening and treatment program in South Korea where hepatitis B virus (HBV) prevails, in people aged 40-70, compared to current practice (no screening).
  
  
  
  A published Markov model was used in conjunction with a screening and treatment decision tree to model patient cohorts, aged 40-49, 50-59 and 60-69 years, distributed across chronic hepatitis C (CHC) and compensated cirrhosis (CC) health states (82.5% and 17.5%, respectively). Based on a published seroepidemiology study, HCV prevalence was estimated at 0.60%, 0.80% and 1.53%, respectively. An estimated 71.7% of the population was screened. Post-diagnosis, 39.4% of patients were treated with a newly available all-oral direct-acting antiviral (DAA) regimen over 5 years. Published rates of sustained virologic response, disease management costs, transition rates and utilities were utilised.
  
  
  
  Screening resulted in the identification of 43,635 previously undiagnosed patients across all cohorts. One-time HCV screening and treatment was estimated to be cost-effective across all cohorts; predicted incremental cost-effectiveness ratios ranged from $5,714 to $8,889 per quality-adjusted life year gained. Incremental costs associated with screening, treatment and disease management ranged from $156.47 to $181.85 million USD; lifetime costs-offsets associated with the avoidance of end stage liver disease complications ranged from $51.47 to $57.48 million USD.
  
  
  
  One-time HCV screening and treatment in South Korean people aged 40-70 is likely to be highly cost-effective compared to the current practice of no screening.
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Do Young
authors.initials: DY
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Kwang-Hyub
authors.initials: KH
authors.lastname: Han
authors.affiliation: Department of Preventive Medicine, Cha University College of Medicine, Kyung-Gi Province, South Korea.
authors.forename: Byungyool
authors.initials: B
authors.lastname: Jun
authors.affiliation: Graduate School of Public Health, Yonsei University, Seoul, South Korea.
authors.forename: Tae Hyun
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Graduate School of Public Health, Yonsei University, Seoul, South Korea.
authors.forename: Sohee
authors.initials: S
authors.lastname: Park
authors.affiliation: HEOR Ltd, Singleton Court Business Park, Monmouth, Wales, United Kingdom.
authors.forename: Thomas
authors.initials: T
authors.lastname: Ward
authors.affiliation: HEOR Ltd, Singleton Court Business Park, Monmouth, Wales, United Kingdom.
authors.forename: Samantha
authors.initials: S
authors.lastname: Webster
authors.affiliation: HEOR Ltd, Singleton Court Business Park, Monmouth, Wales, United Kingdom.|School of Human & Health Sciences, Swansea University, Wales, United Kingdom.
authors.forename: Phil
authors.initials: P
authors.lastname: McEwan
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D005838:Genotype; D016174:Hepacivirus / Q000145:classification / Q000235:genetics; D006526:Hepatitis C / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000821:virology; D006801:Humans; D008390:Markov Chains; D008875:Middle Aged; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D016036:Seroepidemiologic Studies
chemical_list: D000998:Antiviral Agents