Age-Based Hep C Screening May Work Better Than Risk-Based Screening

CHICAGO - A targeted, age-based screening program would result in 59,000 fewer deaths associated with hepatitis C and advanced liver disease, compared with the current risk-based screening program, based on statistical modeling.

Under current U.S. screening practices, “people with no risk factors might not get screened,” Dr. Zobair Younossi of the Inova Health System in Fairfax, Va., said during a press conference in advance of the meetingannual Digestive Disease Week. The results were presented at the annual Digestive Disease Week meeting on May 8.

Individuals with hepatitis C may not show symptoms until decades after they have been infected, he noted. Recent studies have shown that the prevalence of hepatitis C virus (HCV) infection among the “baby boomer plus” population (people born in 1946-1970) in the United States may be higher than expected. “A screening strategy based on age, rather than risk factors, could have a significant impact” on the disease, he said.

Dr. Younossi and colleagues used a Markov model of the natural history of the infection and its complications. They applied the model to a population of approximately 102 million individuals who were eligible for screening, and found that the birth cohort screening (BCS) strategy would result in 59,000 fewer deaths related to HCV infection and 106,000 fewer cases of advanced liver disease, compared with the current risk-based screening (RBS) strategy.

The investigators designed a mathematical model using a birth cohort of individuals who were born in the United States in 1946-1970. They estimated the current hepatitis C status and stage of disease progression using a run-in period from 1964 to 2010, as well as using age- and sex-based rates of infection, progression, and spontaneous clearance. BCS involved the assumption that 100% of the cohort would be screened within the first 5 years, starting in 2010.

The model suggested that BCS would cost approximately $25,000 for each additional quality-adjusted year of life gained. BCS would cost more overall than RBS ($45.1 billion vs. 32.0 billion), but BCS would yield lower costs related to advanced liver disease ($21.7 billion vs. $25.8 billion), Dr. Younossi said. The up-front investment could be worthwhile in terms of reducing long-term medical costs, he said.

“There are better hepatitis C treatments in development that could increase the benefits of screening,” Dr. Younossi said. Effective screening for hepatitis C now may reduce future costs to Medicare, he added.

I have checked the following facts in my story: (Please initial each.)

The study was supported by Vertex Pharmaceuticals. Dr. Younossi has served on advisory committees or review panels for multiple pharmaceutical companies, including Vertex Pharmaceuticals, Salix Pharmaceuticals, and Tibotec. 

*This story has been updated and new information has been added.

CHICAGO - A targeted, age-based screening program would result in 59,000 fewer deaths associated with hepatitis C and advanced liver disease, compared with the current risk-based screening program, based on statistical modeling.

Under current U.S. screening practices, “people with no risk factors might not get screened,” Dr. Zobair Younossi of the Inova Health System in Fairfax, Va., said during a press conference in advance of the meetingannual Digestive Disease Week. The results were presented at the annual Digestive Disease Week meeting on May 8.

Individuals with hepatitis C may not show symptoms until decades after they have been infected, he noted. Recent studies have shown that the prevalence of hepatitis C virus (HCV) infection among the “baby boomer plus” population (people born in 1946-1970) in the United States may be higher than expected. “A screening strategy based on age, rather than risk factors, could have a significant impact” on the disease, he said.

Dr. Younossi and colleagues used a Markov model of the natural history of the infection and its complications. They applied the model to a population of approximately 102 million individuals who were eligible for screening, and found that the birth cohort screening (BCS) strategy would result in 59,000 fewer deaths related to HCV infection and 106,000 fewer cases of advanced liver disease, compared with the current risk-based screening (RBS) strategy.

The investigators designed a mathematical model using a birth cohort of individuals who were born in the United States in 1946-1970. They estimated the current hepatitis C status and stage of disease progression using a run-in period from 1964 to 2010, as well as using age- and sex-based rates of infection, progression, and spontaneous clearance. BCS involved the assumption that 100% of the cohort would be screened within the first 5 years, starting in 2010.

The model suggested that BCS would cost approximately $25,000 for each additional quality-adjusted year of life gained. BCS would cost more overall than RBS ($45.1 billion vs. 32.0 billion), but BCS would yield lower costs related to advanced liver disease ($21.7 billion vs. $25.8 billion), Dr. Younossi said. The up-front investment could be worthwhile in terms of reducing long-term medical costs, he said.

“There are better hepatitis C treatments in development that could increase the benefits of screening,” Dr. Younossi said. Effective screening for hepatitis C now may reduce future costs to Medicare, he added.

I have checked the following facts in my story: (Please initial each.)

The study was supported by Vertex Pharmaceuticals. Dr. Younossi has served on advisory committees or review panels for multiple pharmaceutical companies, including Vertex Pharmaceuticals, Salix Pharmaceuticals, and Tibotec. 

*This story has been updated and new information has been added.

CHICAGO - A targeted, age-based screening program would result in 59,000 fewer deaths associated with hepatitis C and advanced liver disease, compared with the current risk-based screening program, based on statistical modeling.

Under current U.S. screening practices, “people with no risk factors might not get screened,” Dr. Zobair Younossi of the Inova Health System in Fairfax, Va., said during a press conference in advance of the meetingannual Digestive Disease Week. The results were presented at the annual Digestive Disease Week meeting on May 8.

Individuals with hepatitis C may not show symptoms until decades after they have been infected, he noted. Recent studies have shown that the prevalence of hepatitis C virus (HCV) infection among the “baby boomer plus” population (people born in 1946-1970) in the United States may be higher than expected. “A screening strategy based on age, rather than risk factors, could have a significant impact” on the disease, he said.

Dr. Younossi and colleagues used a Markov model of the natural history of the infection and its complications. They applied the model to a population of approximately 102 million individuals who were eligible for screening, and found that the birth cohort screening (BCS) strategy would result in 59,000 fewer deaths related to HCV infection and 106,000 fewer cases of advanced liver disease, compared with the current risk-based screening (RBS) strategy.

The investigators designed a mathematical model using a birth cohort of individuals who were born in the United States in 1946-1970. They estimated the current hepatitis C status and stage of disease progression using a run-in period from 1964 to 2010, as well as using age- and sex-based rates of infection, progression, and spontaneous clearance. BCS involved the assumption that 100% of the cohort would be screened within the first 5 years, starting in 2010.

The model suggested that BCS would cost approximately $25,000 for each additional quality-adjusted year of life gained. BCS would cost more overall than RBS ($45.1 billion vs. 32.0 billion), but BCS would yield lower costs related to advanced liver disease ($21.7 billion vs. $25.8 billion), Dr. Younossi said. The up-front investment could be worthwhile in terms of reducing long-term medical costs, he said.

“There are better hepatitis C treatments in development that could increase the benefits of screening,” Dr. Younossi said. Effective screening for hepatitis C now may reduce future costs to Medicare, he added.

I have checked the following facts in my story: (Please initial each.)

The study was supported by Vertex Pharmaceuticals. Dr. Younossi has served on advisory committees or review panels for multiple pharmaceutical companies, including Vertex Pharmaceuticals, Salix Pharmaceuticals, and Tibotec. 

*This story has been updated and new information has been added.