A Cost-Effectiveness Analysis of Hepatitis C Screening Among Immigrants in Canada

Posted: 22 Jun 2007

See all articles by Wendong Chen

Wendong Chen

University of Toronto - Department of Health Policy and Management

Katherine Dinner

Public Health Agency of Canada

Tom Wong

Public Health Agency of Canada

Jenny E. Heathcote

University of Toronto - Department of Medicine

Murray Krahn

University of Toronto - Department of Medicine; University of Toronto - University Health Network

Date Written: June 2007

Abstract

AIM: The costs and benefits of hepatitis C (HCV) screening among immigrants need to be assessed since about 20% of HCV cases in Canada are immigrants. METHODS: A decision analytic model was developed to assess HCV screening among immigrants. The prevalence of hepatitis C and distributions of viral genotypes among immigrants were projected by the studies related to HCV epidemiology in their home countries. Meta-analyses of randomized trials were conducted to estimate the effectiveness of current anti-viral therapy (pegylated interferon plus ribavirin) in terms of genotype and disease stage. Survival regression model and logistic regression model were applied to project the transition probabilities for the disease progression by identifying cohort studies on the natural history of chronic HCV. The awareness of the disease, and the HCV incidence among immigrants were estimated using PHAC's surveillance data. The costs associated with HCV screening test, anti-viral therapy, and health care were estimated through published literatures. RESULTS: HCV screening was associated with an increase of life years (0.0013 years) and cost ($40.6) when compared to no screening for all immigrants ($30,552 per additional life year). HCV screening for immigrants born in South Asia was associated with longer life years (0.0108 years) and less cost (-$50.6). HCV screening strategy for immigrants born in Africa cost $8,635 to gain one additional life year. No obvious advantages of HCV screening were observed for immigrants from other areas. CONCLUSION: The preliminary findings suggest that it may be cost-effectiveness to screen immigrants from South Asia and Africa in Canada.

Suggested Citation

Chen, Wendong and Dinner, Katherine and Wong, Tom and Heathcote, Jenny E. and Krahn, Murray, A Cost-Effectiveness Analysis of Hepatitis C Screening Among Immigrants in Canada (June 2007). iHEA 2007 6th World Congress: Explorations in Health Economics Paper, Available at SSRN: https://ssrn.com/abstract=993132

Wendong Chen (Contact Author)

University of Toronto - Department of Health Policy and Management ( email )

155 College Street
Suite 425
Toronto, Ontario M5T 3M6
Canada

Katherine Dinner

Public Health Agency of Canada ( email )

Canada

Tom Wong

Public Health Agency of Canada ( email )

Canada

Jenny E. Heathcote

University of Toronto - Department of Medicine ( email )

Toronto
Canada

Murray Krahn

University of Toronto - Department of Medicine ( email )

Toronto
Canada

University of Toronto - University Health Network ( email )

101 College Street
Toronto, ON M5G 1L7 ON M5G 1L7
Canada

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