Cost‐effectiveness and health‐related outcomes of screening for hepatitis C in Korean population

Background/Aim In the era of direct‐acting antivirals (DAA), active screening for hidden hepatitis C virus (HCV) infection is important for HCV elimination. This study estimated the cost‐effectiveness and health‐related outcomes of HCV screening and DAA treatment of a targeted population in Korea, where anti‐HCV prevalence was 0.6% in 2015. Methods A Markov model simulating the natural history of HCV infection was used to examine the cost‐effectiveness of two strategies: no screening vs screening and DAA treatment. Screening was performed by integration of the anti‐HCV test into the National Health Examination Program. From a healthcare system's perspective, the cost‐utility and the impact on HCV‐related health events of one‐time anti‐HCV screening and DAA treatment in Korean population aged 40‐65 years was analysed with a lifetime horizon. Results The HCV screening and DAA treatment strategy increased quality‐adjusted life years (QALY) by 0.0015 at a cost of $11.27 resulting in an incremental cost‐effectiveness ratio (ICER) of $7435 per QALY gained compared with no screening. The probability of the screening strategy to be cost‐effective was 98.8% at a willingness‐to‐pay of $27 205. Deterministic sensitivity analyses revealed the ICERs were from $4602 to $12 588 and sensitive to screening costs, discount rates and treatment acceptability. Moreover, it can prevent 32 HCV‐related deaths, 19 hepatocellular carcinomas and 15 decompensated cirrhosis per 100 000 screened persons. Conclusions A one‐time HCV screening and DAA treatment of a Korean population aged 40‐65 years would be highly cost‐effective, and significantly reduce the HCV‐related morbidity and mortality compared with no screening.