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Background <p>Hepatitis 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.</p> Methods <p>A 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&#xa0;years), screening duration (10 or 30&#xa0;years), and frequency (once in 2026, or repeated every 10, 5, 3, 2&#xa0;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.</p> Results <p>Universal 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&#xa0;years every 5&#xa0;years for 10&#xa0;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.</p> Conclusions <p>Universal HCV screening every 5&#xa0;years for individuals aged 3–80&#xa0;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.</p>

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Cost–benefit analysis of universal screening for HCV infection in China: a Markov modelling study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月30日

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  • Dachuang Zhou,
  • Liangxiu Xu,
  • Yimei Zhong,
  • Zhehong Xu,
  • Jun Wang,
  • Yuntian Wang,
  • Yiyang Gao,
  • Jing Xie,
  • Yuting Xia,
  • Wenxi Tang

摘要

Background

Hepatitis 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.

Methods

A 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.

Results

Universal 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.

Conclusions

Universal 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.