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 23 May 2018

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News

Treatment scale-up to achieve global HCV incidence and mortality elimination targets

The latest issue of Gut developed a cost-effectiveness model to achieve global HCV incidence and mortality elimination targets.

News image

The WHO's draft HCV elimination targets propose an 80% reduction in incidence and a 65% reduction in HCV-related deaths by 2030.

Dr Nick Scott and colleagues estimated the treatment scale-up required and cost-effectiveness of reaching these targets among injecting drug use-acquired infections using Australian disease estimates.

A mathematical model of HCV transmission, liver disease progression and treatment among current and former people who inject drugs.

Treatment scale-up and the most efficient allocation to priority groups were determined.

5662 courses per year were required, prioritized to patients with advanced liver disease, to reach the mortality target
Gut

Total healthcare and treatment costs, quality-adjusted life years, and incremental cost-effectiveness ratios compared with inaction were calculated.

The research team found that 5662 courses per year were required, prioritized to patients with advanced liver disease, to reach the mortality target.

The researchers noted that 4725 courses per year were required, prioritized to people who inject drugs, to reach the incidence target.

The team observed that this also achieved the mortality target, but to avoid clinically unacceptable HCV-related deaths an additional 5564 treatments per year were required for 5 years for patients with advanced liver disease.

Achieving both targets in this way cost $A4.6 billion more than inaction, but gained 184,000 quality-adjusted life years, giving an incremental cost-effectiveness ratio of $A25,121 per quality-adjusted life year gained.

Dr Scott's team commented, "Achieving WHO elimination targets with treatment scale-up is likely to be cost-effective, based on Australian HCV burden and demographics."

"Reducing incidence should be a priority to achieve both WHO elimination goals in the long-term."

Gut 2017;66:1507-1515
31 July 2017

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