Grant: Travel Awards - Institute Community Support

Chronic Hepatitis C virus (HCV) infection is a major cause of cirrhosis, liver disease, liver failure and liver cancer, affecting almost 1% of the Canadian population. Emergency department (ED) patients have been identified as a high-risk group associated with a significantly higher prevalence of HCV infection when compared to the general Canadian population. Although newly approved medications have revolutionized the treatment of HCV infection, finding and treating cases before serious complications develop is difficult due to the asymptomatic nature of the disease. Screening programs are necessary to find and treat cases before complications develop. The feasibility of alternative and/or expanded HCV screening strategies will depend on a comparison between each strategy's projected costs and health effects. The aim of this study is to use health economic modeling to evaluate ED population screening within a Canadian context. To do this, a health economic model was developed to conduct a cost-utility analysis of opt-in ED HCV screening from the public healthcare payer perspective. Costs in Canadian dollars were used to capture the financial and economic burden of HCV infection while effectiveness measures, such as quality adjusted life years, were used to evaluate associated health outcomes and disease burden. Preliminary study results have identified that ED screening demonstrates the potential to be a cost-effective and feasible alternative to wide-scale population screening strategies. Importantly, although studies have analyzed population screening approaches, few have examined targeted screening of high-risk populations such as ED patients. This analysis provides the first step towards the development of pilot studies and programs of ED-based screening strategies to establish and inform policy pertaining to the screening of ED populations and their potential ability to connect HCV-infected patients to life-saving treatment.