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Table 1 Studies modelling the cost-effectiveness of antiviral therapy for hepatitis C virus infection in people who inject drugs (PWID)

From: Urgent action to fight hepatitis C in people who inject drugs in Europe

Reference Country/setting Design Intervention and population Cost impact
PegIFN/RBV therapy
Martin et al. 2012 [70] United Kingdom Dynamic disease progression and transmission model pegIFN/RBV at mild stage vs no treatment (best supportive care) in: ICER for treating current PWID vs no treatment, according to baseline chronic HCV prevalence:
Probablistic cost-utility analysis Current PWID 20 % prevalence: ICER treat PWID vs no treatment = £521/QALY
Direct medical costs (2010 prices) Non/ex PWID 40 % prevalence: ICER vs no treatment = £2539/QALY
N = 1000 individuals 60 % prevalence: ICER = £7675a/QALY
Treatment of non/ex-PWID dominant at 60 % prevalence; ICER £6803/QALY vs no treatment
Visconti et al. 2013 [71] Australia Markov decision-analytic model pegIFN/RBV at mild (F0/1) stage vs no treatment (best supportive care) in: Current PWID: $AUS 7941/QALY
Direct medical costs (2011 prices) Current PWID Former PWID: $AUS 5808/QALY
Former PWID Non-injectors: $AUS 3985/QALY
Non-injectors Treatment at mild stage dominated treatment at later stages for all cohorts
N = 1000 individuals
DAA therapy     
Bennett et al. 2015 [58] United Kingdom Dynamic model of disease progression, transmission and treatment Uptake increased to 250 per 1000 PWID of: 2015–2027
Current treatment Current treatment: £23.4 million saved (£5.4 after discounting)
New DAA (SVR90%) SVR90%: £36.3 million saved (£8.4 million after discounting)
Lifetime complication rates, costs of complications N = 4240 individuals
Hellard et al. 2015 [72] Australia Closed compartmental model of disease progression and treatment IFN-free DAA at Late treatment vs no treatment: $AUS5078
Early stage (from F0) Early treatment vs late treatment: $AUS17,090
Fixed rate of re-infection Late-stage (from F2/3)
Direct healthcare costs (2014 prices) N = 1000 individuals
Scott et al. 2016 [73] Australia Open compartmental model of progression, transmission and treatment DAA treatment scale up necessary to achieve WHO goals of 65 % reduction in HCV-related deaths and 80 % reduction in HCV incidence by 2030 via two scenarios if DAA treatment for IDU-acquired HCV prioritised to: Patients with advanced liver disease (F ≥ 3) or Current PWID Prioritising advanced liver disease: Mortality target required 5662 (95 % CI 5202–6901) courses/year (30/1000 IDU-acquired infections)
Prioritising PWID:
Incidence and mortality targets achieved with 4725 (95 % CI 3278–8420) courses per year (59/1000 PWID)
Additional 5564 (1959–6917) treatments/year (30/1000 IDU-acquired infections) required for 5 years for patients with advanced liver disease to avoid excess HCV-related deaths
ICER: $AUS25,121 ($AUS11,062–$AUS39,036)/QALY
  1. DAA direct acting agents, F0–3 METAVIR score, ICER incremental cost-effectiveness ratio, pegIFN/RBV peglyated interferon/ribavirin, QALY quality-adjusted life-years, SVR sustained virological response
  2. aCalculated from data in published source