肝炎ウイルス検診の費用対効果分析 : 新潟県の検診データから考える

概要

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The aim of this study was to clarify the cost - effectiveness of the Japanese screening program for hepatitis C by analyzing the data of Niigata pref. A Markov model was constructed to demon - strate the life expectancy (LE) and the lifetime cost over 30 years. The screening was conducted dividing into two groups, one was assumed to be the general population and the other was to be the high risk group in which people had hepatic dysfunction or received blood transfusions, operations previously. In our cost - effectiveness analysis, LE and the lifetime cost including the screening cost in each group were compared between the case when people received both the screening and the anti - viral therapy (the screening case) , and the case when people received neither the screening nor the anti - viral therapy ( no screening case) . The incremental cost -effectiveness ratio of the screening case in the general population and that in the high risk group were calculated to be \1,900,166/LE gained and \2,039,653/LE gained, respectively, which were lower than the cost - effectiveness threshold of $50,000 (=\5,750,000). When we re - analyzed the cost - effectiveness by changing the parameters in our Markov model, the superiority in the cost - effectiveness of the screening case was unchanged.