{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T05:03:04Z","timestamp":1782968584071,"version":"3.54.5"},"reference-count":46,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T00:00:00Z","timestamp":1638835200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100015668","name":"Ontario Ministry of Research and Innovation","doi-asserted-by":"publisher","award":["Early Research Award"],"award-info":[{"award-number":["Early Research Award"]}],"id":[{"id":"10.13039\/501100015668","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>Hepatitis C virus (HCV) continues to pose significant public health concerns with approximately 44% of chronically infected Canadians undiagnosed. The current HCV screening in Canada is a two\u2010step diagnosis pathway consisting of anti\u2010HCV testing and HCV ribonucleic acid (RNA) testing. The introduction of HCV point\u2010of\u2010care assays, such as the Xpert HCV viral load finger\u2010stick assay, can facilitate HCV RNA diagnosis during a single visit and provide quick linkage to care. We evaluated the cost\u2010effectiveness of HCV point\u2010of\u2010care testing compared with current HCV screening strategies for injection drug users (IDUs) from a Canadian provincial Ministry of Health perspective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A state\u2010transition model based on published literature was developed to compare HCV point\u2010of\u2010care assay with the standard\u2010of\u2010care blood screening for a one\u2010time HCV screening and treatment program. It adopted a lifetime time horizon and included health states related to treatment, fibrosis stages, and advanced liver disease clinical states. Outcomes were expressed in costs, quality\u2010adjusted life years (QALYs), and incremental cost\u2010effectiveness ratios. Sensitivity analyses were conducted to assess the robustness of the model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>HCV point\u2010of\u2010care assay generated an additional 0.035 QALYs\/person at a cost reduction of $21.15 compared with the standard\u2010of\u2010care screening. The results were the most sensitive to the specificity of HCV point\u2010of\u2010care assay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The implementation of HCV point\u2010of\u2010care screening in Canada is likely to be cost\u2010saving for IDUs. Early detection and treatment of undiagnosed individuals can prolong people's life span and save healthcare costs associated with HCV\u2010related complications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.15123","type":"journal-article","created":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T23:16:43Z","timestamp":1638314203000},"page":"787-795","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Cost\u2010effectiveness analysis of hepatitis C virus (HCV) point\u2010of\u2010care assay for HCV screening"],"prefix":"10.1111","volume":"42","author":[{"given":"Vanessa","family":"Koo","sequence":"first","affiliation":[{"name":"School of Pharmacy University of Waterloo  Waterloo Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Tian","sequence":"additional","affiliation":[{"name":"School of Pharmacy University of Waterloo  Waterloo Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4630-0052","authenticated-orcid":false,"given":"William W. L.","family":"Wong","sequence":"additional","affiliation":[{"name":"School of Pharmacy University of Waterloo  Waterloo Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,12,7]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"World Health Organization.Hepatitis C.2021.https:\/\/www.who.int\/news\u2010room\/fact\u2010sheets\/detail\/hepatitis\u2010c. Accessed September 14 2021."},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0044103"},{"key":"e_1_2_12_4_1","unstructured":"Public Health Agency of Canada.Modelling the Incidence and Prevalence of Hepatitis C Infection and Its Sequelae in Canada 2007.2010.https:\/\/www.canada.ca\/en\/public\u2010health\/services\/infectious\u2010diseases\/surveillance\u2010epidemiology\u2010sexually\u2010transmitted\u2010infections\u2010hep\u2010b\u2010c\/modelling\u2010incidence\u2010prevalence\u2010hepatitis\u2010infection\u2010sequelae.html. Accessed May 28 2021."},{"key":"e_1_2_12_5_1","unstructured":"World Health Organization.Global Health Sector Strategy on Viral Hepatitis 2016\u20102021.2016.https:\/\/www.who.int\/hepatitis\/strategy2016\u20102021\/ghss\u2010hep\/en\/. Accessed March 28 2021."},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiy117"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.14745\/ccdr.v40i19a02"},{"key":"e_1_2_12_8_1","unstructured":"Public Health Agency of Canada.For Health Professionals: Hepatitis C.2021.https:\/\/www.canada.ca\/en\/public\u2010health\/services\/diseases\/hepatitis\u2010c\/health\u2010professionals\u2010hepatitis\u2010c.html. Accessed May 28 2021."},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737159.2017.1400385"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiy114"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2016.08.035"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14227"},{"key":"e_1_2_12_13_1","unstructured":"Canadian Agency for Drugs and Technologies in Health.Guidelines for the Economic Evaluation of Health Technologies: Canada 4thed.2017.https:\/\/www.cadth.ca\/dv\/guidelines\u2010economic\u2010evaluation\u2010health\u2010technologies\u2010canada\u20104th\u2010edition. Accessed May 28 2021."},{"issue":"3","key":"e_1_2_12_14_1","first-page":"103","article-title":"Introduction to cost\u2010effectiveness analysis for clinicians","volume":"90","author":"Cape JD","year":"2013","journal-title":"UTMJ"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2020.102755"},{"issue":"1","key":"e_1_2_12_16_1","first-page":"53","article-title":"Distribution of hepatitis C virus genotypes in Canada: results from the LCDC sentinel health unit surveillance system","volume":"10","author":"Chaudhary R","year":"1999","journal-title":"Can J Infect Dis"},{"key":"e_1_2_12_17_1","volume-title":"TreeAge 2021 Professional [Software]","year":"2021"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1512610"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1613512"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-027491"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.140711"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.144878"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X03261568"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2005.10.013"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.20.7753"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510280333"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14458"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2004.01.005"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.13373"},{"issue":"1","key":"e_1_2_12_30_1","first-page":"53","article-title":"Can we afford to screen and treat hepatitis C virus (HCV) infection in Canada? Latest insight from a Canadian policy model \u2010 A province\u2010by\u2010province analysis","volume":"3","author":"Wong WWL","year":"2020","journal-title":"Can Liver J"},{"key":"e_1_2_12_31_1","unstructured":"Statistics Canada.Consumer Price Index Annual Average Not Seasonally Adjusted.2021.https:\/\/www150.statcan.gc.ca\/t1\/tbl1\/en\/tv.action?pid=1810000501. Accessed May 28 2021."},{"key":"e_1_2_12_32_1","unstructured":"Canadian Institute for Health Information.National Health Expenditure Trends 2020.2021.https:\/\/www.cihi.ca\/sites\/default\/files\/document\/nhex\u2010trends\u20102020\u2010narrative\u2010report\u2010en.pdf. Accessed May 28 2021."},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20200162"},{"key":"e_1_2_12_34_1","unstructured":"Ontario Drug Benefit.eFormulary. Prices are Effective as of August 31 2021.http:\/\/www.health.gov.on.ca\/en\/pro\/programs\/drugs\/odbf_eformulary.aspx. Accessed September 28 2021."},{"key":"e_1_2_12_35_1","unstructured":"Ontario Ministry of Health.Schedule of Benefits for Laboratory Services. Effective July 1 2020.https:\/\/www.health.gov.on.ca\/en\/pro\/programs\/ohip\/sob\/lab\/lab_mn2020.pdf. Accessed May 28 2021."},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(18)30271-1"},{"key":"e_1_2_12_37_1","unstructured":"Foundation for Innovative New Diagnostics.GeneXpert.2021.https:\/\/www.finddx.org\/pricing\/genexpert\/. Accessed May 28 2021."},{"key":"e_1_2_12_38_1","unstructured":"Organisation for Economic Co\u2010operation and Development.Purchasing Power Parities (PPP).2021.https:\/\/data.oecd.org\/conversion\/purchasing\u2010power\u2010parities\u2010ppp.htm. Accessed May 28 2021."},{"key":"e_1_2_12_39_1","unstructured":"Bank of Canada.Daily Digest.2021.https:\/\/www.bankofcanada.ca\/rates\/daily\u2010digest\/. Accessed September 28 2021."},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/736452"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2019.07.005"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.14745\/ccdr.v46i05a07"},{"key":"e_1_2_12_43_1","unstructured":"Statistics Canada.Life Tables Canada Provinces and Territories.2021.https:\/\/www150.statcan.gc.ca\/n1\/en\/catalogue\/84\u2010537\u2010X. Accessed May 28 2021."},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.1095412"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20170048"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.12754"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/jvh.13023"}],"container-title":["Liver International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/liv.15123","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/liv.15123","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/liv.15123","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,27]],"date-time":"2023-08-27T12:56:21Z","timestamp":1693140981000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/liv.15123"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,7]]},"references-count":46,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1111\/liv.15123"],"URL":"https:\/\/doi.org\/10.1111\/liv.15123","archive":["Portico"],"relation":{},"ISSN":["1478-3223","1478-3231"],"issn-type":[{"value":"1478-3223","type":"print"},{"value":"1478-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,7]]},"assertion":[{"value":"2021-06-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}