Global hepatitis C elimination: an investment framework

Pedrana, Alisa; Howell, Jessica; Scott, Nick; Schroeder, Sophia; Kuschel, Christian; Lazarus, Jeffrey V.; Atun, Rifat; Baptista‐Leite, Ricardo; Hoen, Ellen ‘t; Hutchinson, Sharon; Aufegger, Lisa; Peck, Raquel; Sohn, Annette H.; Swan, Tracy; Thursz, Mark; Lesi, Olufunmilayo; Sharma, Manik; Thwaites, John; Wilson, David; Hellard, Margaret

doi:10.1016/s2468-1253(20)30010-8

Cited by 30 publications

(41 citation statements)

References 67 publications

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“…Our findings suggest that under the SQ scenario, economic productivity losses associated with HCV are likely to be approximately 1.5 times the direct healthcare management costs associated with HCV. New evidence is emerging on the indirect social and economic impacts of HCV [ 26 , 27 , 35 – 37 ], which is supported by recent work highlighting that countries may be substantially underestimating how much HCV is costing their economy [ 29 , 38 ]. This may be particularly important for LMICs where the direct costs associated with HCV epidemics may be minimal due to limited health services capacity to manage HCV-related disease.…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, no primary data exist on this for LMIC settings. Lastly, a recent global modelling analysis estimated that reaching the global HCV elimination targets could generate a net US$22.7 billion economic benefit by 2030, primarily as a result of improvements in workforce productivity [ 29 , 38 ]. This model was conducted at the WHO region level for advocacy to highlight how the true costs of HCV burden (and gains from elimination) are being underestimated by only considering the health system perspective, but it did not include country-specific empirical cost estimates and detailed country-level epidemic calibrations, with our analysis undertaking more nuanced modelling to guide decision-making in Pakistan.…”

Section: Discussionmentioning

confidence: 99%

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Health and economic benefits of achieving hepatitis C virus elimination in Pakistan: A modelling study and economic analysis

et al. 2021

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Background Modelling suggests that achieving the WHO incidence target for hepatitis C virus (HCV) elimination in Pakistan could cost US$3.87 billion over 2018 to 2030. However, the economic benefits from integrating services or improving productivity were not included. Methods and findings We adapt a HCV transmission model for Pakistan to estimate the impact, costs, and cost-effectiveness of achieving HCV elimination (reducing annual HCV incidence by 80% by 2030) with stand-alone service delivery, or partially integrating one-third of initial HCV testing into existing healthcare services. We estimate the net economic benefits by comparing the required investment in screening, treatment, and healthcare management to the economic productivity gains from reduced HCV-attributable absenteeism, presenteeism, and premature deaths. We also calculate the incremental cost-effectiveness ratio (ICER) per disability-adjusted life year (DALY) averted for HCV elimination versus maintaining current levels of HCV treatment. This is compared to an opportunity cost-based willingness-to-pay threshold for Pakistan (US$148 to US$198/DALY). Compared to existing levels of treatment, scaling up screening and treatment to achieve HCV elimination in Pakistan averts 5.57 (95% uncertainty interval (UI) 3.80 to 8.22) million DALYs and 333,000 (219,000 to 509,000) HCV-related deaths over 2018 to 2030. If HCV testing is partially integrated, this scale-up requires an investment of US$1.45 (1.32 to 1.60) billion but will result in US$1.30 (0.94 to 1.72) billion in improved economic productivity over 2018 to 2030. This elimination strategy is highly cost-effective (ICER = US$29 per DALY averted) by 2030, with it becoming cost-saving by 2031 and having a net economic benefit of US$9.10 (95% UI 6.54 to 11.99) billion by 2050. Limitations include uncertainty around what level of integration is possible within existing primary healthcare services as well as a lack of Pakistan-specific data on disease-related healthcare management costs or productivity losses due to HCV. Conclusions Investment in HCV elimination can bring about substantial societal health and economic benefits for Pakistan.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Health and economic benefits of achieving hepatitis C virus elimination in Pakistan: A modelling study and economic analysis

et al. 2021

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“…In response to the increased prevalence of HCV in PWID, the WHO has recommended yearly screening for HCV in this group [ 67 ]. Despite these recommendations, there have been lower rates of HCV testing and treatment among PWID.…”

Section: Hcvmentioning

confidence: 99%

A Focused Review on Recent Advances in the Diagnosis and Treatment of Viral Hepatitis

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The global burden of viral hepatitis remains substantial despite advances in antiviral therapy and effective vaccines. There are five hepatitis viruses (hepatitis A, B, C, D, and E). Mortality related to hepatitis B virus and hepatitis C virus infections is among the top four global infectious diseases, together with human immunodeficiency virus infection, malaria, and tuberculosis. Of those deaths, approximately 47% are attributable to hepatitis B virus, 48% to hepatitis C virus and the remainder to hepatitis A virus and hepatitis E virus. Ending hepatitis epidemics as a major public health threat is feasible with the tools and approaches currently available. Effective vaccines are available for preventing viral hepatitis A, B and E infections. New oral, well-tolerated treatment regimens for chronic hepatitis C patients can achieve cure rates of over 90%. Effective treatment is also available for people with chronic hepatitis B virus infection; although for most people such treatment needs to be long-term, and recent advanced aim at a "functional cure" of hepatitis B. In this review article, we discuss the most recent advances of the diagnosis and treatment of viral hepatitis.

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“…To improve access to care, Pharma companies should allow low‐ and middle‐income countries to have access to new treatments through appropriate transfer technology (generic) policies. There are multiple proposed strategies; however, to find real solutions, it is necessary that policy‐makers and the World Trade Organization evaluate this inequity and find appropriate solutions 7,11 . Finally, it is necessary to establish educational and prevention programs and carry out periodic screening in high‐risk populations in which the prevalence of infection is increasing in the region, especially in men who have sex with men, people with HIV, and injecting drug users.…”

Section: What Is Lacking In Latin America To Achieve the Who’s Goals?mentioning

confidence: 99%

Hepatitis C Virus Infection: What Are We Currently Doing in Latin America About WHO's Proposals for 2030?

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Global hepatitis C elimination: an investment framework

Cited by 30 publications

References 67 publications

Health and economic benefits of achieving hepatitis C virus elimination in Pakistan: A modelling study and economic analysis

Health and economic benefits of achieving hepatitis C virus elimination in Pakistan: A modelling study and economic analysis

A Focused Review on Recent Advances in the Diagnosis and Treatment of Viral Hepatitis

Hepatitis C Virus Infection: What Are We Currently Doing in Latin America About WHO's Proposals for 2030?

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