Cost-Effectiveness of Screening and Treating Chronic Hepatitis C Virus Infection in Zimbabwe

Blessing Dzingirai (), Leolin Katsidzira, Maarten J. Postma, Marinus van Hulst and Nyashadzaishe Mafirakureva
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Blessing Dzingirai: Department of Health Sciences, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
Leolin Katsidzira: Department of Medicine, College of Health Sciences, University of Zimbabwe, Harare P.O. Box MP 167, Zimbabwe
Maarten J. Postma: Department of Health Sciences, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
Marinus van Hulst: Department of Health Sciences, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
Nyashadzaishe Mafirakureva: Sheffield Centre for Health and Related Research, School of Medicine and Population Health, University of Sheffield, Sheffield S10 2TN, UK

IJERPH, 2025, vol. 22, issue 4, 1-15

Abstract: Background: The aim of this study was to assess the cost effectiveness of a screening and treatment intervention approach for chronic HCV infection in Zimbabwe. Methods: Using a decision tree and a validated Markov model, we estimated the lifetime costs and health effects of screening for and treating HCV infections from a healthcare perspective. We evaluated three screening strategies, namely the following: i. no screening; ii. screening among the general population; and iii. screening among high-risk groups. Incremental cost effectiveness ratios were calculated for the strategies that were not dominated. We used deterministic and probabilistic sensitivity analyses to explore the impacts of parameter uncertainty on cost effectiveness outcomes. Results: The strategy of screening among high-risk groups and treating with sofosbuvir/velpatasvir had an incremental cost of USD 1201 and incremental quality-adjusted life years (QALY) of 2.01, yielding an incremental cost effectiveness ratio (ICER) of USD 604 per QALY gained as compared to no screening. The ICER was below the 0.5 times the gross domestic product per capita parameter (USD 796), making the intervention potentially cost effective. The strategy to screen among the general population was dominated, because it costed more and resulted in fewer QALYs than its comparators. Conclusions: Screening for HCV among high-risk populations followed by treatment using sofosbuvir/velpatasvir is cost effective under the assumptions made in this study.

Keywords: hepatitis C virus; cost effectiveness analysis; low- to middle-income countries; directly acting antivirals; Zimbabwe (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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