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Estimating the cost-effectiveness of detecting cases of chronic hepatitis C infection on reception into prison

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Sutton, A. J., Edmunds, W. John and Gill, O. N.. (2006) Estimating the cost-effectiveness of detecting cases of chronic hepatitis C infection on reception into prison. BMC Public Health, Vol. 6 (No. 17). ISSN 1471-2458

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Abstract

Background
In England and Wales where less than 1% of the population are Injecting drug users (IDUs), 97% of HCV reports are attributed to injecting drug use. As over 60% of the IDU population will have been imprisoned by the age of 30 years, prison may provide a good location in which to offer HCV screening and treatment. The aim of this work is to examine the cost effectiveness of a number of alternative HCV case-finding strategies on prison reception

Methods
A decision analysis model embedded in a model of the flow of IDUs through prison was used to estimate the cost effectiveness of a number of alternative case-finding strategies. The model estimates the average cost of identifying a new case of HCV from the perspective of the health care provider and how these estimates may evolve over time.

Results
The results suggest that administering verbal screening for a past positive HCV test and for ever having engaged in illicit drug use prior to the administering of ELISA and PCR tests can have a significant impact on the cost effectiveness of HCV case-finding strategies on prison reception; the discounted cost in 2017 being £2,102 per new HCV case detected compared to £3,107 when no verbal screening is employed.

Conclusion
The work here demonstrates the importance of targeting those individuals that have ever engaged in illicit drug use for HCV testing in prisons, these individuals can then be targeted for future intervention measures such as treatment or monitored to prevent future transmission.

Item Type: Journal Article
Subjects: H Social Sciences > HN Social history and conditions. Social problems. Social reform
Divisions: Faculty of Science > Life Sciences (2010- ) > Biological Sciences ( -2010)
Library of Congress Subject Headings (LCSH): Hepatitis C -- Great Britain, Prisoners -- Medical care, Drug addicts -- Great Britain
Journal or Publication Title: BMC Public Health
Publisher: BioMed Central Ltd.
ISSN: 1471-2458
Official Date: 27 June 2006
Volume: Vol. 6
Number: No. 17
Identification Number: 10.1186/1471-2458-6-170
Status: Peer Reviewed
Access rights to Published version: Open Access
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URI: http://wrap.warwick.ac.uk/id/eprint/555

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