Targeted HCV screening in people who inject drugs cost effective

Objective: We aimed to assess the cost-effectiveness of hepatitis C virus (HCV) screening strategies among recently arrived migrants in the Netherlands. Methods: A Markov model was used to estimate the health effects and costs of HCV screening from the healthcare perspective. A cohort of 50,000 recently arrived migrants was used. In this cohort, three HCV screening strategies were evaluated: (i) no screening, (ii) screening of migrants from HCV-endemic countries and (iii) screening of all migrants. Results: Strategy (ii) screening of migrants from HCV-endemic countries compared to strategy (i) no screening, yielded an incremental cost-effectiveness ratio (ICER) of €971 per quality-adjusted life-years (QALYs) gained. Strategy (iii) screening of all migrants compared with strategy (ii) screening of migrants from HCV-endemic countries yielded an ICER of €1005 per QALY gained. The budget impact of strategy (ii) screening of migrants from HCV-endemic countries and strategy (iii) screening of all migrants was €13,752,039 and €20,786,683, respectively. Conclusion: HCV screening is cost-effective. However, the budget impact may have a strong influence on decision making.

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Eradicating hepatitis C: Are novel screening strategies for people who inject drugs cost-effective?

International Journal of Drug Policy ◽

10.1016/j.drugpo.2020.102811 ◽

2020 ◽

Vol 82 ◽

pp. 102811 ◽

Cited By ~ 1

Author(s):

Francesco Manca ◽

Emma Robinson ◽

John F Dillon ◽

Kathleen Anne Boyd

Keyword(s):

Hepatitis C ◽

People Who Inject Drugs ◽

Cost Effective ◽

Screening Strategies

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Prevalence and risk factors for HBV and HCV among incarcerated people who inject drugs in Iran: a cross sectional study

10.21203/rs.2.24162/v2 ◽

2020 ◽

Author(s):

Ghobad Moradi ◽

Parvin Mohamadi ◽

Bushra Zareie ◽

Mohammad Aziz Rasouli ◽

Mohammad Mehdi Gouya ◽

...

Keyword(s):

Risk Factors ◽

People Who Inject Drugs ◽

Cross Sectional Study ◽

Study Data ◽

Cross Sectional ◽

Hbv Vaccination ◽

Multi Stage ◽

The Status ◽

History Of ◽

Hcv Screening

Abstract Background: This study aimed at determining the prevalence of and risk factors for hepatitis B virus (HBV) and hepatitis C virus (HCV) among incarcerated people who inject drugs (PWID) in Iran during 2015-16. Methods : The required data was collected from a database provided by Iranian national bio-behavioral surveillance surveys (BBSSs) of 11988 prisoners who were selected using multi-stage sampling method from among 55 prisons in 19 provinces during 2015-16. The data on demographics and behavioral status of subjects were collected through interviews and the status of HBV and HCV exposure were determined using ELISA blood test. A total of 1387 individuals with a lifetime history of drug injection were enrolled into the study. Data were analyzed using the survey package in Stata/SE 14.0. Univariate and multivariate logistic regression were used to investigate the relationships between risk factors and outcomes. Results : The mean age of the incarcerated PWID was 36.83 ± 8.13 years. Of all, 98.46% were male and 50.97% were married. The prevalence of HCV and HBV were 40.52% and 2.46%, respectively. HCV prevalence was associated with age≥30 years, being single, illiteracy and low level of education, prison term>5 years, history of piercing, and extramarital sex in a lifetime (P<0.05). Conclusions : The prevalence of HCV is alarmingly high. In general, it is recommended to adopt measures for HCV screening and treatment and HBV vaccination for incarcerated PWID without a history of vaccination.

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Evaluating the impact and cost-effectiveness of scaling-up HCV treatment among people who inject drugs in Ukraine

10.1101/2021.12.13.21267712 ◽

2021 ◽

Author(s):

Jack Stone ◽

Josephine G Walker ◽

Sandra Bivegete ◽

Adam Trickey ◽

Charles Chasela ◽

...

Keyword(s):

Cost Effectiveness ◽

People Who Inject Drugs ◽

Cost Effective ◽

Treatment Rate ◽

Hcv Treatment ◽

Disability Adjusted Life ◽

Life Years ◽

Hcv Transmission ◽

Preventative Interventions ◽

The Impact

Introduction People who inject drugs (PWID) in Ukraine have a high prevalence of hepatitis C virus (HCV). Since 2015, PWID have been receiving HCV treatment, but their impact and cost-effectiveness has not been estimated. Methods We developed a dynamic model of HIV and HCV transmission among PWID in Ukraine, incorporating ongoing HCV treatment (5,933 treatments) over 2015-2021; 46.1% among current PWID. We estimated the impact of these treatments and different treatment scenarios over 2021-2030: continuing recent treatment rates (2,394 PWID/year) with 42.5/100% among current PWID, or treating 5,000/10,000 current PWID/year. We also estimated the treatment rate required to decrease HCV incidence by 80% if preventative interventions are scaled-up or not. Required costs were collated from previous studies in Ukraine. We estimated the incremental cost-effectiveness ratio (ICER) of the HCV treatments undertaken in 2020 (1,059) by projecting the incremental costs and disability adjusted life years (DALYs) averted over 2020-2070 (3% discount rate) compared to a counterfactual scenario without treatment from 2020 onwards. Results On average, 0.4% of infections among PWID were treated annually over 2015-2021, without which HCV incidence would have been 0.6% (95%CrI: 0.3-1.0%) higher in 2021. Continuing existing treatment rates could reduce HCV incidence by 10.2% (7.8-12.5%) or 16.4% (12.1-22.0%) by 2030 if 42.5% or 100% of treatments are given to current PWID, respectively. HCV incidence could reduce by 29.3% (20.7-44.7%) or 93.9% (54.3-99.9%) by 2030 if 5,000 or 10,000 PWID are treated annually. To reduce incidence by 80% by 2030, 19,275 (15,134-23,522) annual treatments are needed among current PWID, or 17,955 (14,052-21,954) if preventative interventions are scaled-up. The mean ICER was US$828.8/DALY averted; cost-effective at a willingness-to-pay threshold of US$3,096/DALY averted (1xGDP). Implications Existing HCV treatment is cost-effective but has had little preventative impact due to few current PWID being treated. Further treatment expansion for current PWID could significantly reduce HCV incidence.

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Universal HCV screening of pregnant women cost effective

PharmacoEconomics & Outcomes News ◽

10.1007/s40274-019-5648-5 ◽

2019 ◽

Vol 821 (1) ◽

pp. 31-31

Keyword(s):

Pregnant Women ◽

Cost Effective ◽

Hcv Screening

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Cost effectiveness of simplified HCV screening-and-treatment interventions for people who inject drugs in Dar-es-Salaam, Tanzania

International Journal of Drug Policy ◽

10.1016/j.drugpo.2021.103458 ◽

2022 ◽

Vol 99 ◽

pp. 103458

Author(s):

Zameer Mohamed ◽

Nick Scott ◽

Shevanthi Nayagam ◽

John Rwegasha ◽

Jessie Mbwambo ◽

...

Keyword(s):

Cost Effectiveness ◽

People Who Inject Drugs ◽

Dar Es Salaam ◽

Treatment Interventions ◽

Hcv Screening

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Is Adding HCV Screening to the Antenatal National Screening Program in Amsterdam, The Netherlands, Cost-Effective?

PLoS ONE ◽

10.1371/journal.pone.0070319 ◽

2013 ◽

Vol 8 (8) ◽

pp. e70319 ◽

Cited By ~ 15

Author(s):

Anouk T. Urbanus ◽

Marjolijn van Keep ◽

Amy A. Matser ◽

Mark H. Rozenbaum ◽

Christine J. Weegink ◽

...

Keyword(s):

The Netherlands ◽

Screening Program ◽

Cost Effective ◽

Hcv Screening

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Intervention Packages to Reduce the Impact of HIV and HCV Infections Among People Who Inject Drugs in Eastern Europe and Central Asia: A Modeling and Cost-effectiveness Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy040 ◽

2018 ◽

Vol 5 (3) ◽

Cited By ~ 8

Author(s):

Guillaume Mabileau ◽

Otilia Scutelniciuc ◽

Maia Tsereteli ◽

Ivan Konorazov ◽

Alla Yelizaryeva ◽

...

Keyword(s):

Cost Effectiveness ◽

Cost Saving ◽

Eastern Europe ◽

Central Asia ◽

People Who Inject Drugs ◽

Cost Effective ◽

High Impact ◽

Hiv Diagnosis ◽

Republic Of Moldova ◽

The Impact

Abstract Background We evaluated the effectiveness and cost-effectiveness of interventions targeting hepatitis C virus (HCV) and HIV infections among people who inject drugs (PWID) in Eastern Europe/Central Asia. We specifically considered the needle-syringe program (NSP), opioid substitution therapy (OST), HCV and HIV diagnosis, antiretroviral therapy (ART), and/or new HCV treatment (direct acting antiviral [DAA]) in Belarus, Georgia, Kazakhstan, Republic of Moldova, and Tajikistan. Methods We developed a deterministic dynamic compartmental model and evaluated the number of infections averted, costs, and incremental cost-effectiveness ratios (ICERs) of interventions. OST decreased frequencies of injecting by 85% and NSP needle sharing rates by 57%; ART was introduced at CD4 <350 and DAA at fibrosis stage ≥F2 at a $2370 to $23 280 cost. Results Increasing NSP+OST had a high impact on transmissions (infections averted in PWID: 42% in Tajikistan to 55% in Republic of Moldova for HCV; 30% in Belarus to 61% in Kazakhstan for HIV over 20 years). Increasing NSP+OST+ART was very cost-effective in Georgia (ICER = $910/year of life saved [YLS]), and was cost-saving in Kazakhstan and Republic of Moldova. NSP+OST+ART and HIV diagnosis was very cost-effective in Tajikistan (ICER = $210/YLS). Increasing the coverage of all interventions was always the most effective strategy and was cost-effective in Belarus and Kazakhstan (ICER = $12 960 and $21 850/YLS); it became cost-effective/cost-saving in all countries when we decreased DAA costs. Conclusion Increasing NSP+OST coverage, in addition to ART and HIV diagnosis, had a high impact on both epidemics and was very cost-effective and even cost-saving. When HCV diagnosis was improved, increased DAA averted a high number of new infections if associated with NSP+OST.

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PREVENTION COULD BE LESS COST-EFFECTIVE THAN CURE: THE CASE OF HEPATITIS C SCREENING POLICIES IN FRANCE

International Journal of Technology Assessment in Health Care ◽

10.1017/s026646230300059x ◽

2003 ◽

Vol 19 (4) ◽

pp. 632-645 ◽

Cited By ~ 17

Author(s):

Sandrine Loubière ◽

Michel Rotily ◽

Jean-Paul Moatti

Keyword(s):

Cost Effectiveness ◽

Hepatitis C ◽

General Population ◽

Intravenous Drug User ◽

Cost Effective ◽

Screening Strategy ◽

Additional Cost ◽

Alternative Strategies ◽

Hcv Screening ◽

The Cost

Objectives: To access the cost-effectiveness of French recommendations for hepatitis C virus (HCV) screening and the extent to which earlier identification of carriers may or not improve the cost-effectiveness of therapeutic strategies.Methods: Cost-effectiveness analysis were performed using decision-tree analysis and a Markov model. Four alternative strategies were compared: no screening and no treatment; initiation of HCV treatment after the diagnosis of cirrhosis; and two alternative strategies refer to the current French policies of HCV testing, i.e., two enzyme immunoblot assay (EIA) tests in series, or a polymerase chain reaction (PCR) analysis after the first positive EIA test. Costs were computed from the viewpoint of the health care system. The analysis has been applied to populations particularly at risk of infection, as well as the general population.Results: The “wait and treat cirrhosis” strategy was more cost-effective in the general population and in transfusion recipients. The incremental cost-effectiveness ratio of this strategy compared with baseline strategy was 3,476 of euros and €15,300 in respective cohorts. Considering the HCV screening strategy, the additional cost would be of €4,933 and €240,250 per additional year of life saved, respectively. In the intravenous drug user (IDU) population, the “two EIA” screening strategy was the more cost-effective alternative, with an additional cost of €3,825 per additional year of life saved.Conclusions: HCV screening would be discarded for transfusion recipients but should be encouraged for IDUs and also for the general population, in which the additional cost of screening is an order of magnitude more acceptable.

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