Abstract
Interventions aimed at the diagnosis of viral hepatitis in migrants from countries with high prevalence rates are essential to achieve the elimination of viral hepatitis. The objective was to perform a cost-effectiveness analysis of a community screening strategy for hepatitis B and C virus (HBV and HCV) infections versus no intervention in migrant populations in Catalonia. HBV and HCV decision trees for the community strategy (from community screening to simplified access to care and treatment) and Markov models to simulate hepatitis B and C disease progression were developed. Sensitivity analyses were performed with the parameters with the highest uncertainty. Among the 2291 people screened, 74 and 21 cases of HBV and HCV infection were diagnosed, which avoided 79% and 62% of liver complications related to HBV and HCV, respectively. Community HCV screening showed an incremental cost of €13,999/patient versus no intervention and 2.98 quality-adjusted life years (QALYs) per patient, resulting in an incremental cost‒utility ratio of €4692/QALY gained. The HBV strategy was dominant. The distribution of HCV patients across different fibrosis stages had a greater impact on sensitivity analyses. Implementing a community screening strategy, which also increased awareness of HBV and HCV infections and treatment in migrant populations, is cost-effective.
Acknowledgements
The authors especially thank all study participants, civil society associations, and community health workers of the Community & Public Health Team (Drassanes-Vall d’Hebron Centre for International Health and Infectious Diseases). The authors also thank other members of the HepBC link study group including Hakima Ouaarab Essadek (Community & Public Health Team, ESPIC), Laia Ferrer, Laura Fernández, Juliana Reyes-Ureña, and Esteve Muntada (CEEISCAT), Laura Muntané and Antoni E. Bordoy (Germans Trias i Pujol Research Institute, IGTP), Begoña Treviño (Hepatology Department, Hospital Universitari Vall Hebrón), Rosa Mª Morillas (Hepatology Unit, Hospital Universitari Germans Trias i Pujol). The IGTP has received support from the CERCA Program/Generalitat de Catalunya.
Funding
This study and the HepBClink project were funded to E. Martró by the Instituto de Salud Carlos III (Co-funded by European Regional Development Fund "A way to make Europe", grant number PI19/0568). A.N. held a PFIS grant (Instituto de Salud Carlos III, Fondo Social Europeo; grant number FI20/00211). The MiCatC project was funded by Gilead Sciences to J. Colom; the funder of the project had no role in study design, data collection, data analysis, data interpretation, writing of the report or the decision to publish.
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EM has received lecture fees and research grants from Abbott GmbH & Co.K.G., Gilead Sciences, Cepheid and Abbvie, outside of the submitted work. RDH and MGB are employees of Pharmacoeconomics & Outcomes Research Iberia (PORIB), a consulting firm specializing in the economic evaluation of health care interventions that has received financing for the development of the project that is not conditional upon the results. MB: has received lecture fees and research grants from Abbvie, GSK and Gilead Sciences, outside of the submitted work. VF, JG, AN, SML, MM, JC, XM and JC declare no competing interest.
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Martró, E., Domínguez-Hernández, R., Forero, V. et al. Cost-effectiveness of community interventions to promote awareness, testing and treatment of hepatitis B and C in migrant populations in Catalonia. Sci Rep (2026). https://doi.org/10.1038/s41598-026-53044-y
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DOI: https://doi.org/10.1038/s41598-026-53044-y
