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

Table 4 Diagnostic accuracy, health outcomes and costs in alcoholic liver disease patients

Diagnostic accuracy (%)1		Biopsy	ELF/LSM	ELF
Liver fibrosis (F ≥ 2)
TP		47.7	38.6	47.7
FN		5.3	14.4	5.3
TN		42.3	45.2	24.4
FP		4.7	1.8	22.6
Cirrhosis (F4)
TP		18.1	15.6	18.1
FN		2.0	4.5	2.0
TN		71.9	73.5	42.3
FP		8.0	6.4	37.5
Frequency of events (%)	No testing	Single	Annual	Annual
		Biopsy	ELF/LSM	ELF
Compensated cirrhosis (new cases)	51.8	49.7	39.0	27.8
Decompensated cirrhosis	64.7	61.4	38.7	30.2
Hepatocellular carcinoma	10.2	9.8	7.3	5.8
Fibrosis-related death	68.8	66.5	54.8	44.4
QALYs, costs and ICER	No testing	Single	Annual	Annual
		Biopsy	ELF/LSM	ELF
QALYs	9.2	9.55	10.88	11.94
Cost per patient (€)	13 985	14 209	14 581	14 661
ICER relative to “no testing”		640	355	247
ICER relative to biopsy			280	189

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.