Dzingirai Blessing, Katsidzira Leolin, Postma Maarten J, Hulst Marinus van, Mafirakureva Nyashadzaishe
Department of Health Sciences, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands.
Department of Pharmacy and Pharmaceutical Sciences, University of Zimbabwe, Harare P.O. Box MP 167, Zimbabwe.
Int J Environ Res Public Health. 2025 Mar 27;22(4):509. doi: 10.3390/ijerph22040509.
The aim of this study was to assess the cost effectiveness of a screening and treatment intervention approach for chronic HCV infection in Zimbabwe.
Using a decision tree and a validated Markov model, we estimated the lifetime costs and health effects of screening for and treating HCV infections from a healthcare perspective. We evaluated three screening strategies, namely the following: i. no screening; ii. screening among the general population; and iii. screening among high-risk groups. Incremental cost effectiveness ratios were calculated for the strategies that were not dominated. We used deterministic and probabilistic sensitivity analyses to explore the impacts of parameter uncertainty on cost effectiveness outcomes.
The strategy of screening among high-risk groups and treating with sofosbuvir/velpatasvir had an incremental cost of USD 1201 and incremental quality-adjusted life years (QALY) of 2.01, yielding an incremental cost effectiveness ratio (ICER) of USD 604 per QALY gained as compared to no screening. The ICER was below the 0.5 times the gross domestic product per capita parameter (USD 796), making the intervention potentially cost effective. The strategy to screen among the general population was dominated, because it costed more and resulted in fewer QALYs than its comparators.
Screening for HCV among high-risk populations followed by treatment using sofosbuvir/velpatasvir is cost effective under the assumptions made in this study.
本研究旨在评估津巴布韦慢性丙型肝炎病毒（HCV）感染筛查及治疗干预方法的成本效益。
我们使用决策树和经过验证的马尔可夫模型，从医疗保健角度估算HCV感染筛查和治疗的终身成本及健康影响。我们评估了三种筛查策略，即：i. 不筛查；ii. 普通人群筛查；iii. 高危人群筛查。对未被占优的策略计算增量成本效益比。我们使用确定性和概率性敏感性分析来探讨参数不确定性对成本效益结果的影响。
高危人群筛查并用索磷布韦/维帕他韦治疗的策略增量成本为1201美元，增量质量调整生命年（QALY）为2.01，与不筛查相比，每获得一个QALY的增量成本效益比（ICER）为604美元。该ICER低于人均国内生产总值参数的0.5倍（796美元），这使得该干预措施可能具有成本效益。普通人群筛查策略被占优，因为其成本更高且QALY比其比较对象少。
在本研究的假设条件下，高危人群中进行HCV筛查然后使用索磷布韦/维帕他韦治疗具有成本效益。
