Should patients with abnormal liver function tests in primary care be tested for chronic viral hepatitis: cost minimisation analysis based on a comprehensively tested cohort

Table 7 Economic analysis

Strategy	Cost per 100 patients (£)*	Cases detected per 100 patients	Cost per case detected (£)	Incremental cost per 100 patients (with base = E)	Incremental cases detected per 100 patients (base = E)	ICER
A	5222	1.05	4965	5159	0.61	Dominated**
B	1592	0.70	2270	1530	0.26	Dominated^†
C	293	0.53	558	231	0.09	(2635)^‡
D	570	0.89	641	508	0.45	1124
E (base)^§	62	0.44	142	0	0.00	Base
F	837	0.96	868	775	0.53	1473
G	4052	1.05	3853	3990	0.61	6503

* Cost of Viral test = £40.52; Cost of LFT Panel = £17.79.
** Dominated by G.
† Dominated by D and F.
‡ Strategy C is eliminated by extended dominance.
§ Patient born in a country of intermediate to high viral hepatitis prevalence and ALT greater than twice upper limit of normal on primary test is the least expensive strategy and was considered as base case.
ICER: Incremental cost-effectiveness ratio.
LFT: Liver function test.

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