IDEAS home Printed from
   My bibliography  Save this article

Cost Effectiveness of Hepatitis C-Related Interventions Targeting Substance Users and Other High-Risk Groups


  • Ava John-Baptiste


  • Man Yeung
  • Victoria Leung
  • Gabrielle Velde
  • Murray Krahn


Background and Objective: In developed countries, injection drug users have the highest prevalence and incidence of hepatitis C virus (HCV) infection. Clinicians and policy makers have several options for reducing morbidity and mortality related to HCV infection, including preventing new infections, screening high-risk populations, and optimizing uptake and delivery of antiviral therapy. Cost-effectiveness analyses provide an estimate of the value for money associated with adopting healthcare interventions. Our objective was to determine the cost effectiveness of hepatitis C interventions (prevention, screening, treatment) targeting substance users and other groups with a high proportion of substance users. Methods: We conducted a systematic search of MEDLINE, EMBASE, CINAHL, HealthSTAR and EconLit, and the grey literature. Studies were critically appraised using the Drummond and Jefferson, Neumann et al. and Philips et al. checklists. We developed and applied a quality appraisal instrument specific to cost-effectiveness analyses of HCV interventions. In addition, we summarized cost-effectiveness estimates using a single currency and year ($US, year 2009 values). Results: Twenty-one economic evaluations were included, which addressed prevention (three), screening (ten) and treatment (eight). The quality of the analyses varied greatly. A significant proportion did not incorporate important aspects of HCV natural history, disease costs and antiviral therapy. Incremental cost-effectiveness ratios (ICERs) ranged from dominant (less costly and more effective) to $US603 352 per QALY. However, many ICERs were less than $US100 000 per QALY. Screening and treatment interventions involving pegylated interferon and ribavirin were generally cost effective at the $US100000 per QALY threshold, with the exception of some subgroups, such as immune compromised patients with genotype 1 infections. Conclusions: No clear consensus emerged from the studies demonstrating that prevention, screening or treatment provides better value for money as each approach can be economically attractive in certain subgroups. More high-quality economic evaluations of preventing, identifying and treating HCV infection in substance users are needed. Copyright Springer International Publishing AG 2012

Suggested Citation

  • Ava John-Baptiste & Man Yeung & Victoria Leung & Gabrielle Velde & Murray Krahn, 2012. "Cost Effectiveness of Hepatitis C-Related Interventions Targeting Substance Users and Other High-Risk Groups," PharmacoEconomics, Springer, vol. 30(11), pages 1015-1034, November.
  • Handle: RePEc:spr:pharme:v:30:y:2012:i:11:p:1015-1034
    DOI: 10.2165/11597660-000000000-00000

    Download full text from publisher

    File URL:
    Download Restriction: Access to full text is restricted to subscribers.

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    1. Takeru Shiroiwa & Yoon-Kyoung Sung & Takashi Fukuda & Hui-Chu Lang & Sang-Cheol Bae & Kiichiro Tsutani, 2010. "International survey on willingness-to-pay (WTP) for one additional QALY gained: what is the threshold of cost effectiveness?," Health Economics, John Wiley & Sons, Ltd., vol. 19(4), pages 422-437.
    Full references (including those not matched with items on IDEAS)

    More about this item


    Access and download statistics


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:pharme:v:30:y:2012:i:11:p:1015-1034. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Sonal Shukla) or (Rebekah McClure). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.