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. Author manuscript; available in PMC: 2024 Jul 1.
Published in final edited form as: J Pediatr. 2023 Apr 4;258:113409. doi: 10.1016/j.jpeds.2023.113409

Table 1.

Epidemiologic inputs, annual transition rates, health state utility values and health state costs used in cost-effectiveness analysis of testing approaches for infants perinatally exposed to hepatitis C virus, United States, 2022

Base
Case		 Lower-Upper Source
Strategies: Anti-HCV with reflex to HCV RNA at 18
P HCV RNA+ among pregnant persons (%) 0.64 0.32 – 1.28 22
P of HCV RNA+ pregnant persons screened (%) 44.7 25.0 – 65.0 23
P of infant being tested (no perinatal exposure; %) 75.0 65.0 – 85.0 25
P of infant being tested (perinatal exposure; %) 43.0 35.0 – 52.0 24
P of HCV infection among infants perinatally exposed (%) 5.8 4.2 - 7.8 3
Anti-HCV sensitivity (18 mo; %) 98.1 92.6 – 99.7 21
Anti-HCV specificity (18 mo; %) 99.8 99.2 – 99.9 21
P of maternal antibodies (18 mo; %) 1.6 0.5 – 4.5 12
Reflex HCV RNA sensitivity (18 mo; %) 100 87.5 – 100 19
Reflex HCV RNA specificity (18 mo; %) 100 98.3 −100 19
P of Spontaneous clearance (%) 20.0 15.0 −25.0 28
P of SVR among treated (%) 99 92.4 −100 27
Strategies: HCV RNA test at 2–6 months
P HCV RNA+ among pregnant persons (%) 0.64 0.32 – 1.28 23
P of HCV RNA+ pregnant persons screened (%) 44.7 25.0 – 65.0 23
P of infant being tested (no perinatal exposure; %) 85.0 75.0 – 95.0 25
P of infant being tested (perinatal exposure; %) 73.5 68.0 - 81.0 24
P of HCV infection among infants perinatally exposed (%) 5.8 4.2 – 7.8 3
RNA test sensitivity (2–6 mo; %) 100 87.5 – 100 19
RNA test specificity (2–6 mo; %) 100 98.3 – 100 19
P of Spontaneous clearance (%) 20.0 15.0 – 25.0 28
P of SVR among treated (%) 99.0 92.4 – 100 27
Testing Cost Inputs (in 2021 USD)
Anti-HCV test (CPT: 86803) 14.27 10.8 – 17.8 40
HCV RNA quantitative PCR (CPT: 87522) 42.84 32.1 – 53.6 40
Annual Health State Transition Rates
From: To:
Chronic HCV (<18 years) Compensated cirrhosis 0.0018 0.001-0.110 31
Chronic HCV (18+ years) Compensated cirrhosis 0.110 0.075-0.133 31
Compensated cirrhosis Decompensated cirrhosis 0.035 0.027-0.043 27
Compensated cirrhosis HCC 0.024 0.018-0.031 27
Decompensated cirrhosis HCC 0.068 0.030-0.083 27
Decompensated cirrhosis Liver transplant 0.033 0.017-0.049 27
Decompensated cirrhosis Liver-related death 0.216 0.162-0.270 27
HCC Liver transplant 0.033 0.017-0.049 27
HCC Liver-related death 0.411 0.310-0.510 27
Liver transplant Post liver transplant 0.857 0.841-0.876 27
Liver transplant Liver-related death 0.143 0.124-0.159 27
Post liver transplant Liver-related death 0.034 0.024-0.043 27
Health State Utility Values
Chronic HCV 0.806 0.767-0.845 27
Compensated cirrhosis 0.726 0.680-0.772 27
Decompensated cirrhosis 0.657 0.602-0.711 27
Hepatocellular carcinoma 0.717 0.647-0.788 27
Liver transplant 0.500 0.720-0.840 31
Post liver transplant 0.712 0.657-0.767 27
HCV cured (SVR) 0.841 0.801-0.880 27
Annual Health State Costs (2021 USD)
Chronic HCV 882 682-1,138 31,32
Compensated cirrhosis 1,678 1,299-2,166 31,32
Decompensated cirrhosis 22,619 1,350-39,176 31,32
Hepatocellular carcinoma 47,612 27,488-82,467 31,32
Liver transplant 222,824 128,649-385,940 31,32
Post liver transplant 40,243 23,234-69,702 31,32
Cost of treatment 70,200 7,338-94,500 34

Abbreviations: HCV, hepatitis C virus; anti-HCV, hepatitis c virus antibody; P, probability; SVR, sustained virologic response; USD, United States Dollars; CPT, Current Procedural Terminology; CMS CLFS, Centers for Medicare and Medicaid Services Clinical Laboratory Fee Schedule; mo, months; HCC, hepatocellular carcinoma; SVR, sustained virologic response. Notes: Annual health state costs include all costs associated with HCV-related medical care.