Evidence map›Paper›PMID 42771649›Full record

ArticlePLOS global public health2026

Cost and cost-effectiveness of alternative screening and diagnostic pathways for achieving hepatitis C elimination in the country of Georgia.

Josephine G Walker, Irina Tskhomelidze Schumacher, Shaun Shadaker, Tamar Gabunia, Rania A Tohme, Akaki Abutidze, Vladimer Getia, Peter Vickerman

Abstract read
In one paragraph

Article in PLOS global public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Cost-Effectiveness of Hepatitis C Virus Case Finding and Treatment in Eastern Europe and Central Asia.Liver international : official journal of the International Association for the Study of the Liver · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Josephine G WalkerBristol Medical School, University of Bristol, Bristol, United Kingdom.ORCID https://orcid.org/0000-0002-9732-5738
Irina Tskhomelidze SchumacherTask Force for Global Health, Tbilisi, Georgia.
Shaun ShadakerDivision of Viral Hepatitis, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
Tamar GabuniaMinistry of Internally Displaced Persons from Occupied Territories, Health, Labour and Social Affairs, Tbilisi, Georgia.
Rania A TohmeDivision of Viral Hepatitis, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.ORCID https://orcid.org/0000-0003-4441-0338
Akaki AbutidzeAIDS & Clinical Immunology Research Center, Tbilisi, Georgia.
Vladimer GetiaNational Center for Disease Control and Public Health, Tbilisi, Georgia.ORCID https://orcid.org/0000-0001-9337-1908
Peter VickermanBristol Medical School, University of Bristol, Bristol, United Kingdom.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We evaluated the cost and cost-effectiveness of alternative screening pathways during 2018-2022 within Georgia's hepatitis C elimination program, which started in 2015. We calculated patient-level costs (2022 USD$) of hepatitis C treatment with centralized and decentralized diagnostic testing in hospitals, primary healthcare (PHC), harm reduction providers (HRP), or specialized providers (SP) from reimbursement records including the value of donated direct-acting antivirals (DAAs). We model hepatitis C case-finding, transmission, and progression over a 20-year time horizon to project cost-effectiveness of treatment for each screening pathway in terms of cost per quality adjusted life year (QALY), compared to a willingness-to-pay threshold of $1,337. Unit costs of treatment decreased from $3942-$4247 across screening pathways in 2018 to $300-$338 in 2022, primarily due to reductions in DAA costs. The cascade of care varied by screening pathway, with highest hepatitis C virus (HCV) antibody prevalence and percent linked to viremia testing among HRP and SP, while total number of patients screened was highest in hospitals. While DAA costs decreased, the cost of case finding increased during 2018-2022, with the biggest increase in hospital settings mainly due to decreasing yield. The program was not cost-effective with full DAA costs, but excluding DAA costs or using lower 2022 costs make all pathways cost-effective and SP, HRP, and PHC potentially cost-saving. Donated drugs allowed Georgia's HCV elimination program to be cost-effective, while future programs with generic drug costs are likely to be cost-effective. Reductions in yield from hospital screening suggest that later stages of elimination programs should prioritise targeted pathways.

Identifiers

PMID42771649
PMCPMC13596791

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.