ArticleBMC health services research2025
Cost-benefit analysis of universal screening for HCV infection in China: a Markov modelling study.
Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHepatitis C virus (HCV) infection remains a major public health concern in China, contributing substantially to global HCV-related morbidity and mortality. In line with the World Health Organization (WHO) targets for HCV elimination by 2030, this study aimed to evaluate the long-term health and economic outcomes of universal HCV screening strategies in China.
methodsA decision-analytic Markov model was developed to simulate HCV disease progression and healthcare costs over a 30-year time horizon (2026-2055). A total of 81 scenarios were assessed, including 80 universal screening strategies and a no-screening comparator. Strategies varied by age group (3-10, 20-60, 60-80, or 3-80 years), screening duration (10 or 30 years), and frequency (once in 2026, or repeated every 10, 5, 3, 2 years, or annually). Model inputs were derived from published literature and national data. Cost-effectiveness was evaluated using a willingness-to-pay (WTP) threshold based on China's 2023 per capita gross domestic product, with future costs and health outcomes discounted at 5% annually. Deterministic and probabilistic sensitivity analyses were conducted.
resultsUniversal HCV screening was both effective and cost-effective in the majority of scenarios, with 74 out of 80 strategies demonstrating favorable cost-effectiveness ratios. Eighteen strategies met the WHO target for HCV-related mortality reduction before 2040. The most cost-effective approach-screening individuals aged 3-80 years every 5 years for 10 years-yielded an incremental net monetary benefit of US$98.99 billion (95% CI: US$10.18-190.15 billion), while reducing healthcare expenditures by US$126.67 billion compared to no screening. The required investment for screening was US$3.24 billion. Findings were robust in sensitivity analyses.
conclusionsUniversal HCV screening every 5 years for individuals aged 3-80 years over a 10-year period is highly cost-effective in China and supports national efforts toward achieving WHO HCV elimination targets. These results provide evidence to inform policy decisions in China and other middle-income settings.
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