Cost-effectiveness analysis of a new paradigm to simplify testing, monitoring and treatment of hepatitis C virus in the United States.

The hepatitis C virus (HCV) testing and treatment pathway in the United States (US) includes a range of tests and appointments causing delays and loss to follow-up. We assessed the cost-effectiveness of simplifying the pathway using an economic model to estimate health outcomes, cost differences and incremental cost per quality-adjusted life year (QALY) and life year (LY) of the new paradigm compared to the other scenarios. The analysis compared three scenarios, one based on treatment guidelines, one based on real-world practice and a hypothetical scenario with a simplified pathway ("new paradigm"); these differed in testing and treatment process steps and times. The new paradigm resulted in cost reductions between $19,751 and $16,448, and excess QALYs between 0.42 and 0.70, suggesting that simplifying the US HCV patient pathway may be cost-effective and allows a quicker path to successful treatment and reduce the number of patients lost to follow-up.