Routine hepatitis C virus screening in pregnancy: a cost-effectiveness analysis

Am J Obstet Gynecol. 2005 Apr;192(4):1153-61. doi: 10.1016/j.ajog.2004.10.600.


Objective: The purpose of this study was to determine whether routine hepatitis C virus screening in pregnancy is cost-effective.

Study design: A decision tree with Markov analysis was developed to compare 3 approaches to asymptomatic hepatitis C virus infection in low-risk pregnant women: (1) no hepatitis C virus screening, (2) hepatitis C virus screening and subsequent treatment for progressive disease, and (3) hepatitis C virus screening, subsequent treatment for progressive disease, and elective cesarean delivery to avert perinatal transmission. Lifetime costs and quality-adjusted life years were evaluated for mother and child.

Results: In our base case, hepatitis C virus screening and subsequent treatment of progressive disease was dominated (more costly and less effective) by no screening, with an incremental cost of 108 US dollars and a decreased incremental effectiveness of 0.00011 quality-adjusted life years. When compared with no screening, the marginal cost and effectiveness of screening, treatment, and cesarean delivery was 117 US dollars and 0.00010 quality-adjusted life years, respectively, which yields a cost-effectiveness ratio of 1,170,000 US dollars per quality-adjusted life year.

Conclusion: The screening of asymptomatic pregnant women for hepatitis C virus infection is not cost-effective.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Cohort Studies
  • Cost-Benefit Analysis
  • Decision Trees
  • Diagnostic Tests, Routine / economics*
  • Diagnostic Tests, Routine / methods
  • Female
  • Gestational Age
  • Health Care Costs*
  • Hepatitis C / diagnosis*
  • Hepatitis C / economics
  • Hepatitis C / epidemiology
  • Humans
  • Incidence
  • Markov Chains
  • Mass Screening / economics*
  • Mass Screening / methods
  • Middle Aged
  • Postnatal Care / economics
  • Pregnancy
  • Pregnancy Complications, Infectious / diagnosis*
  • Pregnancy Complications, Infectious / economics
  • Pregnancy Complications, Infectious / epidemiology
  • Prenatal Care / economics
  • Quality-Adjusted Life Years
  • United States