Prisoners have a high prevalence of Hepatitis C virus infection compared with the general population in England and Wales and in many locations throughout the world.
This is because of large numbers of injecting drug users that engage in behaviors likely to transmit Hepatitis C being present within prison populations.
It is, therefore, suggested that prison may be an appropriate location for Hepatitis C screening and treatment to be administered.
Using cost-utility analysis, Dr Andrew Sutton and colleagues from the United Kingdom considered the costs and benefits of administering a single round of screening on reception into prison.
|The cost of one round of prison testing and treatment was £54,852|
|Journal of Viral Hepatitis|
The research team evaluated all individuals followed by possible later screening in the community and compared these to individuals who may only be tested and treated in the community at a later date.
The cost of one round of prison testing and treatment was found to be £54,852, although sensitivity analysis showed uncertainty about this estimate.
One-way sensitivity analysis revealed the importance of the parameters describing the progression of chronic Hepatitis C and the discount rates.
While the results presented at baseline would suggest that screening and treatment for Hepatitis C in prisons is not cost-effective, these results are subject to much uncertainty.
Dr Sutton’s team concludes, “The importance of the rates describing the progression of chronic Hepatitis C on the cost-effectiveness of this intervention has been demonstrated.”
“This suggests that future work should be undertaken to gain further insight into the rates that individuals progress to the later stages of chronic Hepatitis C infection.”