Skip to main content
SpringerLink
Log in

Population-Based Testing for Undiagnosed Hepatitis C: A Systematic Review of Economic Evaluations

  • Systematic Review
  • Published:
Applied Health Economics and Health Policy Aims and scope Submit manuscript

Abstract

Background and Objectives

Recognising the significant public health threat posed by hepatitis C, international targets have been established by the World Health Organization with the aim of eradicating the hepatitis C virus (HCV) by 2030. With the availability of safe and effective therapies, the greatest challenge to achieving elimination is the identification and treatment of those currently undiagnosed. This systematic review aimed to identify and appraise the international literature on the cost-effectiveness of birth cohort, universal, and age-based general population testing for identifying people with undiagnosed chronic HCV infection.

Methods

A comprehensive literature search was undertaken in Medline, Embase and grey literature sources to identify studies published between 1 January 2000 and 17 July 2020. Retrieved citations were independently reviewed by two reviewers according to pre-defined eligibility criteria. Data extraction and critical appraisal were completed in duplicate. Study quality, relevance and credibility were assessed using the Consensus for Health Economic Criteria and the ISPOR questionnaires. All costs were reported in 2019 Irish Euro following adjustment for inflation and purchasing power parity. Willingness-to-pay (WTP) thresholds of €20,000 and €45,000 were adopted as reference points for interpreting cost-effectiveness in the narrative synthesis. The systematic review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria.

Results

Overall, 4622 citations were retrieved in the literature search. Of these, 27 studies met the inclusion criteria. Six (22%) of the 27 studies were rated as low quality, 17 (63%) were moderate quality and four (15%) were high quality. Compared with no testing or risk-based testing: 14 of 16 (88%) cost-utility analyses found that birth cohort testing was cost effective, eight of nine (89%) analyses found that universal testing was cost effective, and eight of eight (100%) analyses found that age-based general population testing was cost effective. Cost effectiveness was influenced by disease prevalence and progression, testing and treatment uptake, treatment eligibility of those identified by testing, the cost of treatment and the proportion of those treated that achieve sustained virological response.

Conclusion

Overall, the international evidence supports the potential cost effectiveness of birth cohort, universal, and age-based general population testing, but is caveated by study generalisability, specifically the transferability of findings from one jurisdiction to another, and institutional variations in healthcare delivery systems and budgetary constraints. The cost effectiveness of each approach will vary according to population- and health system-specific characteristics such as epidemiological context, testing coverage, linkage to care and capacity to treat. Given issues regarding the transferability of economic evaluations (for example, model inputs and assumptions) and the significant resources required to implement these interventions, jurisdiction-specific economic evaluations and budget impact analyses will likely be required to inform investment and implementation decisions.

Registration

PROSPERO, CRD42019127159. Registered 29 April 2019.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. World Health Organization. Guidelines for the care and treatment of persons diagnosed with chronic hepatitis C virus infection. Geneva: World Health Organization; 2018. (Licence: CC BY-NC-SA 3.0 IGO).

    Google Scholar 

  2. Modi AA, Liang TJ. Hepatitis C: a clinical review. Oral Dis. 2008;14(1):10–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. World Health Organization. Hepatitis C. https://www.who.int/news-room/fact-sheets/detail/hepatitis-c. Accessed 30 Nov 2021.

  4. Polaris Observatory HCV Collaborators. Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study. Lancet Gastroenterol Hepatol. 2017;2(3):161–76.

    Article  Google Scholar 

  5. Stasi C, Silvestri C, Voller F. Update on hepatitis C epidemiology: unaware and untreated infected population could be the key to elimination. SN Compr Clin Med. 2020;2(12):2808–15.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Han R, Zhou J, François C, et al. Prevalence of hepatitis C infection among the general population and high-risk groups in the EU/EEA: a systematic review update. BMC Infect Dis. 2019;19(1):655.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Bradley H, Hall EW, Rosenthal EM, et al. Hepatitis C virus prevalence in 50 U.S. states and D.C. by sex, birth cohort, and race: 2013–2016. Hepatol Commun. 2020;4(3):355–70.

    Article  PubMed  PubMed Central  Google Scholar 

  8. European Association for the Study of the Liver. EASL recommendations on treatment of hepatitis C 2018. J Hepatol. 2018;69(2):461–511.

    Article  Google Scholar 

  9. World Health Organization. Hepatitis C diagnostics technology landscape. Geneva: World Health Organization; 2019.

    Google Scholar 

  10. World Health Organization. Global Health Sector strategy on viral hepatitis 2016–2021 towards ending viral hepatitis. 2016. https://apps.who.int/iris/bitstream/handle/10665/246177/WHO-HIV-2016.06-eng.pdf?sequence=1. Accessed 30 Nov 2021.

  11. World Health Organization. Combating hepatitis B and C to reach elimination by 2030. Geneva: World Health Organization; 2016.

    Google Scholar 

  12. World Health Organization. Global hepatitis report 2017. Geneva: World Health Organization; 2017. (Licence: CC BY-NC-SA 3.0 IGO).

    Google Scholar 

  13. World Health Organization. Guidelines for the screening, care and treatment of persons with chronic hepatitis C infection. Geneva: World Health Organization; 2016.

    Google Scholar 

  14. World Health Organization. Guidelines on hepatitis B and C testing. Geneva: World Health Organization; 2017. (Licence: CC BY-NC-SA 3.0 IGO).

    Google Scholar 

  15. European Centre for Disease Prevention and Control. Public health guidance on HIV, hepatitis B and C testing in the EU/EEA—an integrated approach. Stockholm: ECDC; 2018.

    Google Scholar 

  16. European Centre for Disease Prevention and Control. Hepatitis B and C epidemiology in selected population groups in the EU/EEA. Stockholm: ECDC; 2018.

    Google Scholar 

  17. European Centre for Disease Prevention and Control. Hepatitis B and C testing strategies in healthcare and community settings in the EU/EEA—a systematic review. Stockholm: ECDC; 2018.

    Google Scholar 

  18. Department of Health. Hepatitis C screening (NCEC National Clinical Guideline No. 15). 2017. http://health.gov.ie/national-patient-safety-office/ncec/national-clinical-guidelines. Accessed 30 Nov 2021.

  19. Dowsett LE, Coward S, Lorenzetti DL, et al. Living with hepatitis C virus: a systematic review and narrative synthesis of qualitative literature. Can J Gastroenterol Hepatol. 2017;2017:3268650.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Irvin R, Ward K, Agee T, et al. Comparison of hepatitis C virus testing recommendations in high-income countries. World J Hepatol. 2018;10(10):743–51.

    Article  PubMed  PubMed Central  Google Scholar 

  21. World Health Organization. Japan’s hepatitis programme frees people from disease and financial hardship. 2018. https://www.who.int/westernpacific/news/feature-stories/detail/japan%E2%80%99s-hepatitis-programme-frees-people-from-disease-and-financial-hardship.

  22. Nakamura J, Terajima K, Aoyagi Y, et al. Cost-effectiveness of the national screening program for hepatitis C virus in the general population and the high-risk groups. Tohoku J Exp Med. 2008;215(1):33–42.

    Article  PubMed  Google Scholar 

  23. Hanson K. Treating Hepatitis C. National Conference of State Legislatures. In: LEGISBRIEF. Briefing papers on the important issues of the day. 2014;22(38). https://www.ncsl.org/documents/health/lb_2238.pdf. Accessed 30 Nov 2021.

  24. University of Calgary. Hepatitis C screening in Alberta: a health technology assessment. University of Calgary; 2016.

    Google Scholar 

  25. Goel A, Sanchez J, Paulino L, et al. A systematic model improves hepatitis C virus birth cohort screening in hospital-based primary care. J Viral Hepat. 2017;24(6):477–85.

    Article  CAS  PubMed  Google Scholar 

  26. Razavi H, Sanchez Gonzalez Y, Yuen C, et al. Global timing of hepatitis C virus elimination in high-income countries. Liver Int. 2020;40(3):522–9.

    Article  PubMed  Google Scholar 

  27. Smith BD, Morgan RL, Beckett GA, et al. Hepatitis C virus testing of persons born during 1945–1965: recommendations from the Centers for Disease Control and Prevention. Ann Intern Med. 2012;157(11):817–22.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Moyer VA. Screening for hepatitis C virus infection in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2013;159(5):349–57.

    Article  PubMed  Google Scholar 

  29. Schillie S, Wester C, Osborne M, et al. CDC recommendations for hepatitis C screening among adults—United States. MMWR Recomm Rep. 2020;69:1–17. https://doi.org/10.1585/mmwr.rr6902a1.

    Article  PubMed  PubMed Central  Google Scholar 

  30. U.S. Preventive Services Task Force. Screening for hepatitis C virus infection in adolescents and adults: a systematic review update for the U.S. Preventive Services Task Force. 2020. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/hepatitis-c-screening. Accessed 30 Nov 2021.

  31. Carty P, Fawsitt C, Teljeur C, et al. Birth cohort screening for hepatitis C: a systematic review of cost-effectiveness. PROSPERO 2019 CRD42019127159. http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42019127159. Accessed 30 Nov 2021.

  32. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and metaanalyses: the PRISMA statement. PLoS Med. 2009;6(7): e1000097. https://doi.org/10.1371/journal.pmed.1000097.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Mandrik O, Severens JL, Bardach A, et al. Critical appraisal of systematic reviews with costs and cost-effectiveness outcomes: an ISPOR good practices task force report. Value Health. 2021;24(4):463–72.

    Article  PubMed  Google Scholar 

  34. Coward S, Leggett L, Kaplan G, et al. Cost-effectiveness of screening for hepatitis C virus: a systematic review of economic evaluations. BMJ Open. 2016;6: e011821.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Scottish Intercollegiate Guidelines Network. Search filters. 2019. https://www.sign.ac.uk/what-we-do/methodology/search-filters/. Accessed 30 Nov 2021.

  36. Covidence. Covidence systematic review software, Veritas Health Innovation, Melbourne, Australia. https://www.covidence.org/home. Accessed 30 Nov 2021.

  37. Evers S, Goossens M, de Vet H, et al. Criteria list for assessment of methodological quality of economic evaluations: consensus on health economic criteria. Int J Technol Assess Health Care. 2005;21(2):240–5.

    Article  PubMed  Google Scholar 

  38. Caro JJ, Eddy DM, Kan H, et al. Questionnaire to assess relevance and credibility of modeling studies for informing health care decision making: an ISPOR-AMCP-NPC good practice task force report. Value Health. 2014;17:174–82.

    Article  Google Scholar 

  39. Health Information and Quality Authority. Guidelines for the retrieval and interpretation of economic evaluations of health technologies in Ireland. 2014. https://www.hiqa.ie/sites/default/files/2017-01/Guidelines-Retrieval-and-Interpretation-of-Econ-Lit.pdf. Accessed 30 Nov 2021.

  40. Health Information and Quality Authority. Guidelines for the budget impact analysis of health technologies in Ireland. 2018. https://www.hiqa.ie/reports-and-publications/health-technology-assessment/guidelines-budget-impact-analysis-health. Accessed 30 Nov 2021.

  41. Health Information and Quality Authority. Guidelines for the economic evaluation of health technologies in Ireland. 2020. https://www.hiqa.ie/reports-and-publications/health-technology-assessment/guidelines-economic-evaluation-health. Accessed 30 Nov 2021.

  42. Zoratti MJ, Siddiqua A, Morassut RE, et al. Pangenotypic direct acting antivirals for the treatment of chronic hepatitis C virus infection: a systematic literature review and meta-analysis. EClinicalMedicine. 2020;18: 100237.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Bansal S, Singal AK, McGuire BM, et al. Impact of all oral anti-hepatitis C virus therapy: a meta-analysis. World J Hepatol. 2015;7(5):806–13.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Holmes JA, Rutledge SM, Chung RT. Direct-acting antiviral treatment for hepatitis C. Lancet. 2019;393(10179):1392–4.

    Article  PubMed  Google Scholar 

  45. Barocas JA, Tasillo A, Yazdi GE, et al. Population-level outcomes and cost-effectiveness of expanding the recommendation for age-based hepatitis C testing in the United States. Clin Infect Dis. 2018;67(4):549–56.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Buti M, Dominguez-Hernandez R, Casado MA, et al. Healthcare value of implementing hepatitis C screening in the adult general population in Spain. PLoS ONE. 2018;13(11): e0208036.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Coffin PO, Scott JD, Golden MR, et al. Cost-effectiveness and population outcomes of general population screening for hepatitis C. Clin Infect Dis. 2012;54(9):1259–71.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Crespo J, Cuadrado A, Perelló C, et al. Epidemiology of hepatitis C virus infection in a country with universal access to direct-acting antiviral agents: data for designing a cost-effective elimination policy in Spain. J Viral Hepat. 2020;27(4):360–70.

    Article  CAS  PubMed  Google Scholar 

  49. Deuffic-Burban S, Huneau A, Verleene A, et al. Assessing the cost-effectiveness of hepatitis C screening strategies in France. J Hepatol. 2018;69(4):785–92.

    Article  PubMed  Google Scholar 

  50. Dimitrova M, Tachkov K, Petrova G. Economic consequences of the implementation of national screening program for chronic HCV infection. Expert Rev Pharmacoecon Outcomes Res. 2019;20:1–8.

    Google Scholar 

  51. Eckman MH, Talal AH, Gordon SC, et al. Cost-effectiveness of screening for chronic hepatitis C infection in the United States. Clin Infect Dis. 2013;56(10):1382–93.

    Article  CAS  PubMed  Google Scholar 

  52. Eckman MH, Ward JW, Sherman KE. Cost effectiveness of universal screening for hepatitis C virus infection in the era of direct-acting, pangenotypic treatment regimens. Clin Gastroenterol Hepatol. 2019;17(5):930-9 e9.

    Article  PubMed  Google Scholar 

  53. Ethgen O, Sanchez Gonzalez Y, Jeanblanc G, et al. Public health impact of comprehensive hepatitis C screening and treatment in the French baby-boomer population. J Med Econ. 2017;20(2):162–70.

    Article  PubMed  Google Scholar 

  54. Kim DY, Han KH, Jun B, et al. Estimating the cost-effectiveness of one-time screening and treatment for hepatitis C in Korea. PLoS ONE. 2017;12(1): e0167770.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Kim DY, Wong G, Lee J, et al. Cost-effectiveness of increased screening and treatment of chronic hepatitis C in Korea. Curr Med Res Opin. 2020;36(6):993–1002.

    Article  CAS  PubMed  Google Scholar 

  56. Kim J, Haacker M, Keshavjee S, et al. Cost-effectiveness of scaling up of hepatitis C screening and treatment: a modelling study in South Korea. BMJ Glob Health. 2019;4(3): e001441.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Kim KA, Chung W, Choi HY, et al. Cost-effectiveness and health-related outcomes of screening for hepatitis C in Korean population. Liver Int. 2018;39(1):60–9.

    Article  PubMed  Google Scholar 

  58. Kondili LA, Gamkrelidze I, Blach S, et al. Optimization of hepatitis C virus screening strategies by birth cohort in Italy. Liver Int. 2020;40(7):1545–55.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Liu S, Cipriano LE, Holodniy M, et al. Cost-effectiveness analysis of risk-factor guided and birth-cohort screening for chronic hepatitis C infection in the United States. PLoS ONE. 2013;8(3): e58975.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. McEwan P, Ward T, Yuan Y, et al. The impact of timing and prioritization on the cost-effectiveness of birth cohort testing and treatment for hepatitis C virus in the United States. Hepatology. 2013;58(1):54–64.

    Article  PubMed  Google Scholar 

  61. McGarry LJ, Pawar VS, Panchmatia HR, et al. Economic model of a birth cohort screening program for hepatitis C virus. Hepatology. 2012;55(5):1344–55.

    Article  PubMed  Google Scholar 

  62. Mendlowitz AB, Naimark D, Wong WWL, et al. The emergency department as a setting-specific opportunity for population-based hepatitis C screening: an economic evaluation. Liver Int. 2020;40(6):1282–91.

    Article  PubMed  Google Scholar 

  63. Nagai K, Ide K, Kawasaki Y, et al. Estimating the cost-effectiveness of screening for hepatitis C virus infection in Japan. Hepatol Res. 2020;50(5):542–56.

    Article  PubMed  Google Scholar 

  64. Opstaele L, Bielen R, Bourgeois S, et al. Who to screen for hepatitis C? A cost-effectiveness study in Belgium of comprehensive hepatitis C screening in four target groups. Acta Gastro Enterol Belg. 2019;82(3):379–87.

    CAS  Google Scholar 

  65. Rein DB, Smith BD, Wittenborn JS, et al. The cost-effectiveness of birth-cohort screening for hepatitis C antibody in U.S. primary care settings. Ann Intern Med. 2011;156(4):263–70.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Ruggeri M, Coretti S, Gasbarrini A, et al. Economic assessment of an anti-HCV screening program in Italy. Value Health. 2013;16(6):965–72.

    Article  PubMed  Google Scholar 

  67. Williams J, Miners A, Harris R, et al. Cost-effectiveness of one-time birth cohort screening for hepatitis C as part of the National Health Service Health Check Program in England. Value Health. 2019;22(11):1248–56.

    Article  PubMed  Google Scholar 

  68. Wong WWL, Erman A, Feld JJ, et al. Model-based projection of health and economic effects of screening for hepatitis C in Canada. CMAJ Open. 2017;5(3):E662–72.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Wong WWL, Tu HA, Feld JJ, et al. Cost-effectiveness of screening for hepatitis C in Canada. CMAJ. 2015;187(3):E110–21.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Younossi Z, Blissett D, Blissett R, et al. In an era of highly effective treatment, hepatitis C screening of the United States general population should be considered. Liver Int. 2018;38(2):258–65.

    Article  PubMed  Google Scholar 

  71. Gray AM, Clarke PM, Wolstenholme JL, et al. Applied methods of cost-effectiveness analysis in health care. Oxford: OUP; 2011.

    Google Scholar 

  72. Woods B, Revill P, Sculpher M, et al. Country-level cost-effectiveness thresholds: initial estimates and the need for further research. Value Health. 2016;19(8):929–35.

    Article  PubMed  PubMed Central  Google Scholar 

  73. Muzembo BA, Mbendi NC, Nakayama SF. Systematic review with meta-analysis: performance of dried blood spots for hepatitis C antibodies detection. Public Health. 2017;153:128–36.

    Article  CAS  PubMed  Google Scholar 

  74. Vazquez-Moron S, Ardizone Jimenez B, Jimenez-Sousa MA, et al. Evaluation of the diagnostic accuracy of laboratory-based screening for hepatitis C in dried blood spot samples: a systematic review and meta-analysis. Sci Rep. 2019;9(1):7316.

    Article  PubMed  PubMed Central  Google Scholar 

  75. Tang W, Chen W, Amini A, et al. Diagnostic accuracy of tests to detect Hepatitis C antibody: a meta-analysis and review of the literature. BMC Infect Dis. 2017;17(Suppl 1):695.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Mason LMK, Veldhuijzen IK, Duffell E, et al. Hepatitis B and C testing strategies in healthcare and community settings in the EU/EEA: a systematic review. J Viral Hepat. 2019;26(12):1431–53.

    Article  PubMed  PubMed Central  Google Scholar 

  77. O’Connell S, Lillis D, Cotter A, et al. Opt-out panel testing for HIV, hepatitis B and hepatitis C in an urban emergency department: a pilot study. PLoS ONE. 2016;11: 112016.

    Article  Google Scholar 

  78. Grant C, O’Connell S, Lillis D, et al. Opt-out screening for HIV, hepatitis B and hepatitis C: observational study of screening acceptance, yield and treatment outcomes. Emerg Med J. 2020;37(2):102–5.

    Article  PubMed  Google Scholar 

  79. Allen N, Faherty C, Davies A, et al. Opt-out bloodborne virus screening: a cross-sectional observational study in an acute medical unit. BMJ Open. 2019;9(7): e022777.

    Article  PubMed  PubMed Central  Google Scholar 

  80. Jhaveri R, Broder T, Bhattacharya D, et al. universal screening of pregnant women for hepatitis C: the time is now. Clin Infect Dis. 2018;67(10):1493–7.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. RCSI University of Medicine and Health Sciences, Dublin, Ireland

    Paul G. Carty

  2. Health Information and Quality Authority, Dublin, Ireland

    Paul G. Carty, Christopher G. Fawsitt, Patricia Harrington, Michelle O’Neill, Conor Teljeur & Mairin Ryan

  3. Health Economics and Policy Analysis Centre, CÚRAM, the SFI Research Centre for Medical Devices (12/RC/2073_2), National University of Ireland Galway, Galway, Ireland

    Paddy Gillespie

  4. Health Research Board Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin, Ireland

    Susan M. Smith

  5. Department of Pharmacology and Therapeutics, Trinity College Dublin, Trinity Health Sciences, St James’s Hospital, Dublin 8, Ireland

    Mairin Ryan

Authors
  1. Paul G. Carty
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christopher G. Fawsitt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Paddy Gillespie
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Patricia Harrington
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michelle O’Neill
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Susan M. Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Conor Teljeur
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mairin Ryan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Paul G. Carty.

Ethics declarations

Funding

This work was conducted as part of the SPHeRE Programme under Grant No. SPHeRE/2013/1. However, no funding was received for this work. Open access publication is sought under the IreL publisher agreement with Springer Nature that allows corresponding authors from the Royal College of Surgeons in Ireland (RCSI) to have articles made open access.

Conflicts of interest/Competing interests

No conflicts of interest.

Availability of data and material

All data used during the preparation of this manuscript are publicly available and can be requested from the corresponding author.

Code availability

Not applicable.

Authors’ Contributions

All authors contributed to the study conception and design. PC performed the literature search and analysis. Data collection and interpretation were performed by PC, CF and CT. PC wrote the manuscript, which was reviewed by all authors. The final manuscript was approved by all authors.

Ethics approval

Not applicable.

Consent to participate

Not applicable.

Consent for publication

Not applicable.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 674 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Carty, P.G., Fawsitt, C.G., Gillespie, P. et al. Population-Based Testing for Undiagnosed Hepatitis C: A Systematic Review of Economic Evaluations. Appl Health Econ Health Policy 20, 171–183 (2022). https://doi.org/10.1007/s40258-021-00694-w

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40258-021-00694-w

Search

Navigation