Cost-effectiveness of enhanced liver fibrosis test to assess liver fibrosis in chronic hepatitis C virus and alcoholic liver disease patients

Table 3 Diagnostic accuracy, health outcomes and costs in hepatitis C virus patients

Diagnostic accuracy (%)1		Biopsy	ELF/LSM	ELF
Liver fibrosis (F ≥ 2)
TP		47.7	37.7	47.7
FN		5.3	15.3	5.3
TN		42.3	44.5	24.4
FP		4.7	2.5	22.6
Cirrhosis (F4)
TP		18.1	15.2	18.1
FN		2.0	4.9	2.0
TN		71.9	71.2	42.3
FP		8.0	8.6	37.5
Frequency of events (%)	No testing	Single	Annual	Annual
		Biopsy	ELF/LSM	ELF
Compensated cirrhosis (new cases)	40.4	16.8	0.9	0.2
Decompensated cirrhosis	24.7	7.0	0.3	0.1
Hepatocellular carcinoma	25.6	7.2	0.3	0.1
Fibrosis-related death	47.9	13.5	0.6	0.2
QALYs, costs and ICER	No testing	Single	Annual	Annual
		Biopsy	ELF/LSM	ELF
QALYs	12.36	15.27	16.33	16.75
Cost per patient (€)	24 353	43 447	57 691	60 443
ICER relative to “no testing”		6 561	8 397	8 221
ICER relative to biopsy			13 438	11 484

¹Percentage of cases detected on first test. Initial prevalence: liver fibrosis = 53%; cirrhosis = 20%. TP: True positives; FN: False negatives; TN: True negatives; FP: False positives; QALY: Quality-adjusted life year; ICER: Incremental cost-effectiveness ratio (€ per QALY); ELF: Enhanced liver fibrosis test; LSM: Liver stiffness measurement.