{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:16:51Z","timestamp":1790140611392,"version":"4.0.1"},"reference-count":28,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,4,2]],"date-time":"2020-04-02T00:00:00Z","timestamp":1585785600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Cost\u2010effective screening strategies are needed to make hepatitis C virus (HCV) elimination a reality. We determined if birth cohort screening is cost\u2010effective in Italy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A model was developed to quantify screening and healthcare costs associated with HCV. The model\u2010estimated prevalence of undiagnosed HCV was used to calculate the antibody screens needed annually, with a \u20ac25\u00a0000 cost\u2010effectiveness threshold. Outcomes were assessed under the status quo and a scenario that met the World Health Organization's targets for elimination of HCV. The elimination scenario was assessed under five screening strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A graduated birth cohort screening\u00a0strategy (graduated\u00a0screening 1:\u00a01968\u20101987 birth cohorts, then expanding to 1948\u20101967 cohorts) was the least costly. This strategy would gain approximately\u00a0144 000 quality\u2010adjusted life years (QALYs) by 2031 and result in an 89.3% reduction in HCV cases, compared to an 89.6%, 89.0%, 89.7% and 88.7% reduction for inversed graduated screening, 1948\u201077 birth cohort, 1958\u201077 birth cohort and universal screening, respectively. Graduated screening 1 yielded the lowest incremental cost\u2010effectiveness ratio (ICER) of \u20ac3552 per QALY gained.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In Italy, a graduated screening scenario is the most cost\u2010effective strategy. Other countries could consider a similar birth cohort approach when developing HCV screening strategies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.14408","type":"journal-article","created":{"date-parts":[[2020,2,20]],"date-time":"2020-02-20T15:51:46Z","timestamp":1582213906000},"page":"1545-1555","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Optimization of hepatitis C virus screening strategies by birth cohort in Italy"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2656-224X","authenticated-orcid":false,"given":"Loreta A.","family":"Kondili","sequence":"first","affiliation":[{"name":"Center for Global Health Istituto Superiore di Sanit\u00e0 Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3843-670X","authenticated-orcid":false,"given":"Ivane","family":"Gamkrelidze","sequence":"additional","affiliation":[{"name":"Center for Disease Analysis Foundation Lafayette CO US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9252-7576","authenticated-orcid":false,"given":"Sarah","family":"Blach","sequence":"additional","affiliation":[{"name":"Center for Disease Analysis Foundation Lafayette CO US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3974-3798","authenticated-orcid":false,"given":"Andrea","family":"Marcellusi","sequence":"additional","affiliation":[{"name":"Centre for Economic and International Studies Faculty of Economics University of Rome Tor Vergata Rome Italy"},{"name":"Department of Accounting Finance and Informatics Kingston Business School Kingston University London 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