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Model shows that screening for hepatitis C in NHS Health Checks could be cost-effective

3 September 2019

Screening for hepatitis C as part of the NHS adult Health Check programme could be cost-effective, according to a study led by researchers from the NIHR Health Protection Research Unit (HPRU) in Evaluation of Interventions, at the University of Bristol, the NIHR HPRU in Blood Borne and Sexually Transmitted Infections at University College London, and the London School of Hygiene and Tropical Medicine.

Smiling GP leans forward over desk in consultation with male patient

The researchers used modelling to calculate the cost-effectiveness of one-time screening for hepatitis C as part of the NHS Health Check programme, which is offered to adults aged 40-74 in England by their GPs.

They found that screening is likely to be cost-effective for people born in the 1970s, but there was uncertainty about whether cost-effectiveness would extend to people born in other time periods (mid-1950s and 1960s).

Jack Williams, lead author of the study and Research Fellow at the London School of Hygiene and Tropical Medicine, said: “There are an estimated 143,000 people living with hepatitis C in England, many of whom will not know that they have the disease. Our analysis suggests that adding one-time birth cohort screening to the NHS Health Check could be a cost-effective way to help identify individuals with hepatitis C. More research is needed, particularly to see whether screening could be effective in other birth cohorts, but these initial results are promising.”

Professor Peter Vickerman, from the NIHR Health Protection Research Unit in Evaluation of Interventions at the University of Bristol, who supervised the study, said: “The National Institute for Health and Clinical Excellence (NICE) highlighted the possibility of adding hepatitis C screening to an existing health service in their hepatitis B and C testing guidelines but stopped short of making a recommendation due to lack of information on cost-effectiveness. Our study goes some way towards filling that information gap. 

“We hope to be able to do further research in this area so that there is a robust evidence base to support future NICE recommendations and help the UK achieve the World Health Organization’s hepatitis C elimination target by 2030.”

Hepatitis C is a virus that is passed on through blood exposure and results in liver disease. It is estimated that over 70 million people are infected with the hepatitis C virus worldwide and that around 400,000 people with hepatitis C die each year due to related conditions such as cirrhosis of the liver and liver cancer.

Paper: The cost-effectiveness of one-time birth cohort screening for hepatitis C as part of the NHS health check programme in England. Jack Williams et al. Published in Value in Health


Further information

About the NIHR HPRU in Evaluation of Interventions at the University of Bristol

The Health Protection Research Unit (HPRU) in Evaluation of Interventions, based in Population Health Sciences at the University of Bristol, is part of the National Institute for Health Research (NIHR) and a partnership between University of Bristol and Public Health England (PHE), in collaboration with University College London, Cambridge Medical Research Council (MRC) Biostatistics Unit and University of the West of England. We are a multidisciplinary team undertaking applied research on the development and evaluation of interventions to protect the public’s health. Our aim is to support PHE in delivering its objectives and functions. Our focus is on the PHE priority area of infection. Follow us on Twitter: @HPRU_EI