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ORIGINAL ARTICLE
Year : 2021  |  Volume : 13  |  Issue : 3  |  Page : 126-132

Economic evaluation of implementing a rapid point-of-care screening test for the identification of hepatitis C virus under National Viral Hepatitis Control Programme in Tamil Nadu, South India

Muniyandi Malaisamy1, Karikalan Nagarajan1, Tyagi Kirti2, Singh Malkeet2, Prakash Venkatesan3, S Senthilkumar1, Karthikeyan Sananthya1, Krishnan Rajendran4, Rajsekar Kavitha2, Shanmugam Vivekanandan5, TS Selvavinayagam3
1 Department of Health Economics, ICMR-National Institute for Research in Tuberculosis, New Delhi, India
2 Department of Health Research, Ministry of Health and Family Welfare, New Delhi, India
3 Department of Public Health and Preventive Medicine, Directorate of Medical and Rural Health Services, Government of Tamil Nadu, Chennai, Tamil Nadu, India
4 Department of Statistics, ICMR-National Institute for Research in Tuberculosis, New Delhi, India
5 Chennai Liver Foundation, Chennai, Tamil Nadu, India

Correspondence Address:
Dr. Muniyandi Malaisamy
Department of Health Economics, ICMR-National Institute for Research in Tuberculosis, Mayor Sathyamoorthy Road, Chetput, Chennai - 600 031, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jgid.jgid_394_20

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Introduction: Viral hepatitis is a crucial public health problem in India. Hepatitis C virus (HCV) elimination is a national priority and a key strategy has been adopted to strengthen the HCV diagnostics services to ensure early and accurate diagnosis. Methods: To conduct an economic evaluation of implementing a rapid point-of-care screening test for the identification of HCV among the selected key population under the National Viral Hepatitis Control Programme in Tamil Nadu, South India. Economic evaluation of a point-of-care screening test for HCV diagnosis among the key population attending the primary health care centers. A combination of decision tree and Markov model was developed to estimate cost-effectiveness of point-of-care screening test for HCV diagnosis at the primary health care centers. Total costs, quality-adjusted life years (QALYs) of the intervention and comparator, and incremental cost-effectiveness ratio (ICER) were calculated. The model parameter uncertainties which would influence the cost-effectiveness outcome has been evaluated by one-way sensitivity analysis and probabilistic sensitivity analysis. Results: When compared to the tertiary level diagnostic strategy for HCV, the point-of-care screening for selected key population at primary health care level results in a gain of 57 undiscounted QALYs and 38 discounted QALYs, four undiscounted life years and two discounted life years. The negative ICER of the new strategy indicates that it is less expensive and more effective compared with the current HCV diagnosis strategy. Conclusions: The proposed strategy for HCV diagnosis in the selected key population in Tamil Nadu is dominant and cost-saving compared to the current strategy.


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