The Health Information and Quality Authority (HIQA) has commenced work on a health technology assessment (HTA) of offering testing for the hepatitis C virus to people in Ireland born between 1965 and 1985.
The aim of the HTA is to establish the clinical- and cost-effectiveness of birth cohort testing for hepatitis C in Ireland. In addition, the assessment will estimate the budget impact of introducing a birth cohort testing programme and assess the organisational and resource implications of such a service. The HTA is scheduled to be finalised in early 2020.
The outcome of this assessment will be provided as advice to the Minister for Health to inform a decision on whether or not to provide birth cohort testing for hepatitis C in Ireland.
Birth cohort testing involves offering one-time testing for the hepatitis C virus to people born during a particular period of time. Compared with risk-based testing, this type of testing avoids the need to identify specific behavioural risks as the basis for testing. Birth cohort testing is conditionally recommended by the World Health Organization in easily-identified age or other demographic groups known to have a prevalence higher than that of the general population.
The 1965 to 1985 birth cohort was identified based on national data, which indicated that the prevalence of hepatitis C infection in Ireland is highest amongst those born between 1965 and 1985 (72.5% of cases).
HIQA’s Director of Health Technology Assessment and Deputy Chief Executive, Dr Máirín Ryan, said: “Hepatitis C is a blood-borne virus that predominantly affects the liver. Although infection can often resolve spontaneously, chronic hepatitis C infection may lead to fibrosis, cirrhosis, liver transplantation and potentially fatal complications such as hepatocellular carcinoma.”
Dr Ryan continued: “The progression of hepatitis C-related disease is often slow and unpredictable. Individuals who are chronically infected may only become aware of their infection status following the development of cirrhosis and its complications. With the availability of highly-effective treatment, there is now an opportunity to identify and cure people living with chronic hepatitis C infection that are currently undiagnosed.”
HIQA has established an expert advisory group comprising representatives from key stakeholder groups who will advise the HTA evaluation team during the course of this assessment.