HealthDay News — Universal opt-out hepatitis C virus (HCV) screening in prisons is cost-effective and can reduce HCV transmission outside of prisons, according to research published online in the Annals of Internal Medicine.

Tianhua He, MD, from the University of Pittsburgh, and colleagues reviewed the literature to examine the health and economic impact of HCV screening and treatment in prisons on the HCV epidemic over a 30-year period.

The researchers found that implementing risk-based and universal opt-out screening could diagnose 41,900 to 122,700 new HCV cases in prisons during the next 30 years. These scenarios could prevent 5,500 to 12,700 new HCV infections caused by released inmates compared with no screening, wherein about 90%of averted infections would have occurred outside prison. An estimated 4,200 to 11,700 liver-related deaths could also be prevented with HCV screening. 


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The incremental cost-effectiveness ratios of screening scenarios ranged from $19,600 to $29,200 per quality-adjusted life-year, and the first-year prison budget was $900 to $1,150 million. To implement such interventions, prisons would require an additional 12.4% of their current health care budget.

“Universal opt-out HCV screening in prisons is highly cost-effective and would reduce HCV transmission and HCV-associated diseases primarily in the outside community,” the authors write. “Investing in U.S. prisons to manage hepatitis C is a strategic approach to address the current epidemic.”

Reference

1. He T, Li K, Roberts MS, et al. Prevention of Hepatitis C by Screening and Treatment in U.S. Prisons. Ann Intern Med. 2015;doi:10.7326/M15-0617.