Research Article Finding Cases of Hepatitis C for Treatment Using Automated Screening in the Emergency Department is Effective, but What Is the Cost? David Stephen Prince , 1,2,3 Julia Di Girolamo, 1,2 Joseph Louis Pipicella , 1,2 Melissa Bagatella, 1 Tahrima Kayes, 1,2 Frank Alvaro, 1,4 Michael Maley, 1,3,4 Hong Foo, 1,4,5 Paul MacConachie Middleton , 1,2,3,6,7 and Miriam Tania Levy 1,2,3 1 Liverpool Hospital, Sydney, NSW, Australia 2 e Ingham Institute for Applied Medical Research, Sydney, NSW, Australia 3 e University of NSW, Sydney, NSW, Australia 4 NSW Health Pathology, Liverpool, NSW, Australia 5 School of Medicine, Western Sydney University, Sydney, NSW, Australia 6 South Western Emergency Research Institute, UNSW, Sydney, NSW, Australia 7 Sydney Medical School, e University of Sydney, Sydney, NSW, Australia Correspondence should be addressed to Miriam Tania Levy; miriam.levy@health.nsw.gov.au Received 27 April 2022; Revised 29 August 2022; Accepted 19 September 2022; Published 14 October 2022 Academic Editor: Yu-Chen Fan Copyright © 2022 David Stephen Prince et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Case detection remains a major challenge for hepatitis C virus (HCV) elimination. We have previously published results from a pilot of an emergency department (ED) semiautomated screening program, SEARCH; Screening Emergency Admissions at Risk of Chronic HCV. Several refinements to SEARCH have been developed to streamline and reduce cost. All direct costs of HCV testing until direct-acting antiviral (DAA) therapy initiation were calculated. Cost was assessed in 2018 Australian Dollars. A cost analysis of the initial program and refinements are presented. Sensitivity analysis to understand impact of variation in staff time, laboratory test cost, changes in HCV antibody (Ab) prevalence, RNA positivity percentage, and rate of linkage to care was conducted. Impact of refinements (SEARCH (2)) to cost is presented. e total SEARCH pilot, testing 5000 patients was estimated to cost $110,549.52 (range $92,109.79–$129,581.24) comprising of $68,278.67 for HCV Ab testing, $21,568.99 for follow-up and linkage to care of positive patients and $20,701.86 to prepare HCV RNA positive patients for treatment. Internal program refinements resulted in a 25% cost reduction. Following refinements, the cost of HCV antibody screening was $8.46 per test and the total cost per positive HCV Ab, positive HCV RNA, and per treated patient were $611.77, $2,168.64, and $3,566.11, re- spectively. Our sensitivity analysis indicates costs per HCV case found are modest so long as HCV Ab prevalence was at least 1%. ED screening is an affordable strategy for HCV case detection and elimination. 1. Introduction Despite curative therapies, chronic hepatitis C virus (HCV) infection remains a global health challenge, in part because reaching and treating those infected requires overcoming significant barriers. e transformative nature of direct acting antiviral (DAA) therapy underpinned the development of World Health Organization’s (WHO) 2030 elimination goals of 80% of eligible patients receiving treatment to achieve a 65% decrease in HCV-related mortality and an 80% decrease in Hindawi Canadian Journal of Gastroenterology and Hepatology Volume 2022, Article ID 3449938, 9 pages https://doi.org/10.1155/2022/3449938