Cost-effectiveness of mass screening for Hepatitis C virus among all inmates in an Irish prison

Ward, Zoe; Mafirakureva, Nyashadzaishe; Stone, Jack; Keevans, Mary; Betts-Symonds, Graham W.; Crowley, Desmond; McHugh, Tina; Avramovic, Gordana; Lambert, John S; Vickerman, Peter

doi:10.1016/j.drugpo.2021.103394

Cited by 10 publications

(8 citation statements)

References 39 publications

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“…In literature, examples of health economic analyses of HCV screening programmes in Europe were performed on high‐risk populations or specific target populations only (i.e. pregnant women, inmates) 19–22 . Results from these studies are discordant, and peculiar aspects of the national health systems, the target population and the cost per treatment in each context should be considered in terms of low generalizability of the results.…”

Section: Discussionmentioning

confidence: 99%

“…pregnant women, inmates). 19 , 20 , 21 , 22 Results from these studies are discordant, and peculiar aspects of the national health systems, the target population and the cost per treatment in each context should be considered in terms of low generalizability of the results. Furthermore, the cost per QALY gained in such analyses heavily depends on the prevalence of HCV infection (up to 16% in Irish inmates) and the cost of the screening programme.…”

Section: Discussionmentioning

confidence: 99%

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Implementation of HCV screening in the 1969–1989 birth‐cohort undergoing COVID‐19 vaccination

D’Ambrosio

Rizzardini

Puoti

et al. 2022

Liver International

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Background and Aim The World Health Organization (WHO) goal of hepatitis C virus (HCV) elimination by 2030 relies on the scaling‐up of both identification and linkage to care of the infected population, worldwide. In Italy, the estimated burden of HCV carriers who are unaware of their infection amounts to 200 000 persons, a projection that reinforces the need for broadening population access to effective screening programmes. Methods A pivotal screening programme targeting subjects born between 1969 and 1989 has been conducted in Lombardy, Northern Italy, where point‐of‐care (POC) testing was offered for free concomitantly to COVID‐19 vaccination. Results Amongst 7219 subjects born between 1969 and 1989 who underwent HCV screening through POC, 7 (0.10%) subjects tested anti‐HCV positive: 5 (0.07%) had confirmed anti‐HCV positivity (Table 1) and 4 of them (0.05%) were HCV‐RNA positive by standard confirmation tests. Conclusions This pivotal study demonstrated the feasibility of a POC‐based anti‐HCV screening programme in young adults undergoing COVID‐19 vaccination. The prevalence of HCV infection in subjects born in the 1969–1989 cohort in Italy seems to be lower than previously estimated. Whether the extension of this programme to subjects born before 1969 could lead to improved screening effectiveness should be a matter of debate.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Implementation of HCV screening in the 1969–1989 birth‐cohort undergoing COVID‐19 vaccination

D’Ambrosio

Rizzardini

Puoti

et al. 2022

Liver International

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“…Testing needs to be scaled up, with a particular focus on testing populations at greatest risk of hepatitis infection including PWID, people in prisons, migrants, men who have sex with men, and people living with HIV in relevant settings, using appropriate testing technologies and methods, and guided by key performance indicators and local epidemiological and testing data. The screening of key populations with high prevalence of infection has been found to be cost effective [26][27][28]. However, testing services remain suboptimal in community-based settings and innovative strategies, like outreach service testing and peer-supported and -led services, could help overcome barriers and making testing more accessible [26][27][28].…”

Section: Plos Global Public Healthmentioning

confidence: 99%

“…The screening of key populations with high prevalence of infection has been found to be cost effective [26][27][28]. However, testing services remain suboptimal in community-based settings and innovative strategies, like outreach service testing and peer-supported and -led services, could help overcome barriers and making testing more accessible [26][27][28]. In scaling up of screening of people in prison settings, active case finding and peersupported interventions have been found to be effective [29,30].…”

Section: Plos Global Public Healthmentioning

confidence: 99%

Monitoring progress towards elimination of hepatitis B and C in the EU/EEA

Sharrock

Noori

Axelsson

et al. 2022

PLOS Glob Public Health

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This paper presents data on selected indicators to show progress towards elimination goals and targets for hepatitis B and hepatitis C in the 31 countries of the European Union (EU) and European Economic Area (EEA). A monitoring system was developed by the European Centre for Disease Prevention and Control, which combined newly collected data from EU/EEA countries along with relevant data from existing sources. Data for 2017 were collected from the EU/EEA countries via an online survey. All countries provided responses. In 2017, most countries reporting data had not reached prevention targets for childhood hepatitis B vaccination and for harm reduction services targeting people who inject drugs (PWID). Four of 12 countries had met the target for proportion of people living with chronic HBV diagnosed and seven of 16 met this target for hepatitis C. Data on diagnosed cases treated were lacking for hepatitis B. Of 12 countries reporting treatment data for hepatitis B, only Iceland met the target. This first collection of data across the EU/EEA highlighted major issues with data completeness and quality and in the indicators that were used, which impairs a clear overview of progress towards the elimination of hepatitis. The available data, whilst incomplete, suggest that as of 2017, the majority of the EU/EEA countries were far from meeting most of the 2020 targets, in particular those relating to harm reduction and diagnosis. It is critical to improve the data collected in order to develop more effective services for hepatitis prevention, diagnosis, and treatment that are needed in order to meet the 2030 elimination targets.

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“…15 Other models have focused on corrections-based treatment programs for infectious diseases associated with substance use disorder, such as HIV and HCV. These models examined the impact of HCV testing and treatment programs in prison in the United Kingdom, Canada, Australia, Ireland, and the United States, showing initiatives are cost-effective [16][17][18][19][20] and can reduce HCV incidence in the community. Similarly, models have shown HIV testing and treatment in prison, jails, or on release is cost-effective in preventing HIV transmission the United States.…”

Section: Modeling Health Interventions In Criminal Justice Settingsmentioning

confidence: 99%

Modeling as Visioning: Exploring the Impact of Criminal Justice Reform on Health of Populations with Substance Use Disorders

Martin,

Beletsky,

Linas

et al. 2023

MDM Policy & Practice

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In the context of historic reckoning with the role of the criminal-legal system as a structural driver of health harms, there is mounting evidence that punitive drug policies have failed to prevent problematic drug use while fueling societal harms. In this explainer article, we discuss how simulation modeling provides a methodological framework to explore the potential outcomes (beneficial and harmful) of various drug policy alternatives, from incremental to radical. We discuss potential simulation modeling opportunities while calling for a more active role of simulation modeling in visioning and operationalizing transformative change. Highlights This article discusses opportunities for simulation modeling in projecting health and economic impacts (beneficial and harmful) of drug-related criminal justice reforms. We call on modelers to explore radical interventions to reduce drug-related harm and model grand alternative futures in addition to more probable scenarios, with a goal of opening up policy discourse to these options.

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Cost-effectiveness of mass screening for Hepatitis C virus among all inmates in an Irish prison

Cited by 10 publications

References 39 publications

Implementation of HCV screening in the 1969–1989 birth‐cohort undergoing COVID‐19 vaccination

Implementation of HCV screening in the 1969–1989 birth‐cohort undergoing COVID‐19 vaccination

Monitoring progress towards elimination of hepatitis B and C in the EU/EEA

Modeling as Visioning: Exploring the Impact of Criminal Justice Reform on Health of Populations with Substance Use Disorders

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