A computer model suggests that screening for hepatitis C virus (HCV) in U.S. prisons and treating infected persons is highly cost-effective and would reduce ongoing HCV transmission, the incidence of advanced liver diseases, and liver-related deaths both inside prison and in the general community. A prison-based screening and treatment program could reduce overall health costs as much as $760 million over a 30-year period and most of those savings would take place in the general community. The study is published in Annals of Internal Medicine.

In the United States, the prevalence of HCV in the noninstitutionalized population is approximately 1.0 percent. The corresponding prevalence in U.S. prisons is 17.3 percent. Liver disease is a frequent cause of death among inmates and in the general society and HCV is the leading cause of liver cancer and the most common indication for liver transplantation. Recent studies have shown that treating HCV in prisons with newer, more effective (and more expensive) agents is feasible and cost-effective. However, cases of HCV must be identified if they are to be treated.

Researchers developed a computer model to project long-term benefits and costs of different HCV screening and treatment scenarios in U.S. prisons. They found that implementing a universal opt-out screening program of inmates would reduce the burden of HCV society-wide because a larger proportion of prisoners released to the community would have been cured of the disease.

Based on these findings, the researchers suggest that greater government resources be allocated to prison health care as an investment in society.