The government is unlikely to designate a hepatitis C antibody test as a health checkup service, although the Korean Association for Study of the Liver has been pushing it for years to fight hepatitis C.

The Ministry of Health and Welfare refused the association’s proposal, citing low cost-effectiveness.

Jeong Young-ki (left), director of the Health Promotion Division at the Ministry of Health and Welfare, and Lee Hyoung-min, director of the Healthcare-Associated Infection Control Division at the Korea Centers for Disease Control and Prevention, attend a policy debate at the National Assembly on Wednesday.

Jeong Young-ki, director of the Health Promotion Division at the Ministry of Health and Welfare, stressed the government’s stance, during a policy debate whether to introduce hepatitis C test as a national health checkup at the National Assembly Hall on Wednesday.

“Since we made the five principles in introducing health checkup items in 2010, we have been faithfully following the principles when adding items. In this sense, adding hepatitis C test has two issues,” Jeong said. One is the low prevalence of hepatitis c, and the other is the low cost-effectiveness of adding hepatitis C screening in the health checkup list, he said.

“The current prevalence of hepatitis C in Korea is 0.6 to 0.7 percent on average. This is false-positive prevalence rate, so in reality, the actual number of hepatitis C patients is very low,” Jeong said.

While the state-supported health checkup is for all citizens, the government’s pilot project on high-risk people did not yield a meaningful result, he said.

In the pilot project, the government tested 77,000 patients for antibodies and found 1,150 positive with 149 of them confirmed with the infection, according to Jeong. “This means that if we screen 1,000 people, we can find two hepatitis C patients and waste money for the other 998,” he said.

Besides, patients who tested positive in the antibody screening need additional expense for confirming the diagnosis, he said.

As there is a cure for hepatitis C, it is important to find the patients, but it does not require national screening, he noted.

The health and welfare ministry plans to conduct a pilot project with the Korea Centers for Disease Control and Prevention (KCDC) to fight hepatitis C next year. After the government collects evidence based on the project, it will discuss an efficient way to fight the disease, Jeong added.

Lee Hyoung-min, director of the Healthcare-Associated Infection Control Division at KCDC, said the government secured 900 million won ($755,000) budget for the hepatitis C early detection program next year. “After conducting the program for two years and accumulating data, we could review the inclusion of hepatitis C screening in the national health test,” he said.

However, Ki Mo-ran, an executive at the Korean Society for Preventive Medicine, said screening hepatitis C was equal to preventing it. Unlike other diseases, hepatitis C should be detected early by screening and treated before the disease worsens, she said.

“In managing infectious diseases, three things are most important – agent control, transmission prevention, and immunogen increase. In hepatitis C, immunogen increase is impossible, so we have to contain it by agent control and transmission prevention,” Ki said. “However, there is no way to block the transmission perfectly. So, detecting the source of infection and treating the patient is the surest way to stop the spread of the infection.”

Unlike other chronic diseases which are manageable in multiple phases, hepatitis C should be controlled at once, and no patient should be left behind, she noted.

“Treating them at once is most cost-effective,” Ki said.

kym@docdocdoc.co.kr

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