KEY OUTCOMES USED TO INFORM DECISION-MAKING IN ECONOMIC EVALUATIONS OF DIAGNOSTIC STRATEGIES IN HEPATITIS C AND D: A TARGETED LITERATURE REVIEW
Author(s)
R. Lakshmi, MSc1, Aishee Ghatak, MSc1, Anurag Gupta, MSc1, Shubham Kumar, MSc1, Paridhi Sharma, MSc1, Tushar Srivastava, MSc2, Aris Skandamis, MSc2, Devian Parra-Padilla, MSc2;
1ConnectHEOR, Delhi, India, 2ConnectHEOR, London, United Kingdom
1ConnectHEOR, Delhi, India, 2ConnectHEOR, London, United Kingdom
OBJECTIVES: Understanding the economic impact of diagnostic strategies for hepatitis C virus (HCV) and hepatitis D virus (HDV) requires consideration of both short and long-term clinical and economic consequences. Economic evaluations of diagnostics typically rely on health economic outcomes, such as the incremental cost-effectiveness ratio (ICER), as the main impact measure. However, payer decision-making may also depend on outcomes reflecting broader implications of testing for healthcare systems. This study reviewed economic evaluations of diagnostic strategies in HCV/HDV to provide an overview of the outcomes used to inform decision-making.
METHODS: A targeted literature search was conducted in PubMed (1 January 2023 to 1 January 2026). Eligible studies were full economic evaluations of diagnostic or screening strategies for HCV/HDV. Data on outcomes informing study conclusions were extracted and compared across studies.
RESULTS: The search identified 122 records for HDV and 589 for HCV. Thirty-five studies met the inclusion criteria (4 HDV; 31 HCV). Most studies (31/35; 89%) relied primarily on ICERs, using quality-adjusted life years (QALYs) or disability-adjusted life years (DALYs) as the main outcomes to inform economic conclusions. Only four studies (4/35; 11%) used alternative primary outcomes, including the number of patients diagnosed, reductions in infections, diagnostic yield, case detection, or loss to follow-up alongside economic results. Outcomes linking diagnostic performance to downstream clinical and healthcare system impacts such as reductions in infections and wider system implications were frequently quantified but were typically not incorporated into cost-effectiveness conclusions, even when not aligned with ICER-based results.
CONCLUSIONS: Economic evaluations of HCV and HDV diagnostic strategies predominantly rely on ICERs and QALY/DALY-based outcomes to quantify clinical and economic impact. These findings highlight the need for broader integration of clinical, diagnostic, and healthcare system-level outcomes in future evaluations to better reflect the value of diagnostic and screening strategies from a payer perspective.
METHODS: A targeted literature search was conducted in PubMed (1 January 2023 to 1 January 2026). Eligible studies were full economic evaluations of diagnostic or screening strategies for HCV/HDV. Data on outcomes informing study conclusions were extracted and compared across studies.
RESULTS: The search identified 122 records for HDV and 589 for HCV. Thirty-five studies met the inclusion criteria (4 HDV; 31 HCV). Most studies (31/35; 89%) relied primarily on ICERs, using quality-adjusted life years (QALYs) or disability-adjusted life years (DALYs) as the main outcomes to inform economic conclusions. Only four studies (4/35; 11%) used alternative primary outcomes, including the number of patients diagnosed, reductions in infections, diagnostic yield, case detection, or loss to follow-up alongside economic results. Outcomes linking diagnostic performance to downstream clinical and healthcare system impacts such as reductions in infections and wider system implications were frequently quantified but were typically not incorporated into cost-effectiveness conclusions, even when not aligned with ICER-based results.
CONCLUSIONS: Economic evaluations of HCV and HDV diagnostic strategies predominantly rely on ICERs and QALY/DALY-based outcomes to quantify clinical and economic impact. These findings highlight the need for broader integration of clinical, diagnostic, and healthcare system-level outcomes in future evaluations to better reflect the value of diagnostic and screening strategies from a payer perspective.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE444
Topic
Economic Evaluation
Disease
SDC: Infectious Disease (non-vaccine)