The phases of hepatitis C elimination: achieving WHO elimination targets

Pedrana, Alisa; Munari, Stephanie; Stoové, Mark; Doyle, Joseph; Hellard, Margaret

doi:10.1016/s2468-1253(20)30366-6

Cited by 36 publications

(47 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This may have contributed to the approximately higher costs accumulated during the campaign compared to some other international studies (€558–2670 [~AUD$884–4231] in 28 and £600–682 [~AUD$1110–1261] in 27 ). However, as Australia moves towards the final stages of elimination (and the backlog of ‘willing and waiting’ people receive treatment 10 ), finding and treating individuals who are disengaged from care will be crucial to ensure elimination are actually achieved.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A modelling analysis of financial incentives for hepatitis C testing and treatment uptake delivered through a community‐based testing campaign

Palmer

Chan

Gold

et al. 2021

Journal of Viral Hepatitis

Self Cite

View full text Add to dashboard Cite

Financial incentives may reduce opportunity costs associated with people who become lost to follow‐up in hepatitis C treatment programs. We estimated the impact that different financial incentive amounts would need to have on retention in care to maintain the same unit cost per (1) RNA‐positive person completing testing (defined as awareness of RNA status) and (2) RNA diagnosed person initiating treatment. Costing data were obtained from a 2019 community‐based testing campaign focused on engaging people who inject drugs. For different financial incentive amounts, we modelled the corresponding improvements in retention in care that would be needed to maintain the same overall (1) unit cost per testing completion and (2) unit cost per treatment initiation. In the testing campaign, the unit cost per RNA‐positive person completing testing was A$3215 and the unit cost per RNA diagnosed person initiating treatment was A$1055. Modelling found that an incentive of A$500 per RNA‐positive person completing testing would result in more people completing testing for the same unit cost if the percentage of attendees receiving their test results increased from 63% to 74%. An incentive of A$200 per RNA diagnosed person initiating treatment would result in more people initiating treatment for the same unit cost if the percentage initiating treatment increased from 67% to 83%. Monetary incentives for completing testing and initiating treatment may be an effective way to increase retention in care without increasing the overall unit cost of completing testing/initiating treatment.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Despite this, recent reports show that the number of people initiating treatment is declining, 8 putting Australia at risk of not meeting the WHO 2030 elimination targets 9 . Hence, new approaches to help engage and support people with hepatitis C into care are needed 10 …”

Section: Introductionmentioning

confidence: 99%

A modelling analysis of financial incentives for hepatitis C testing and treatment uptake delivered through a community‐based testing campaign

Palmer

Chan

Gold

et al. 2021

Journal of Viral Hepatitis

Self Cite

View full text Add to dashboard Cite

show abstract

“…It is consistent with there being different phases in a country's hepatitis C elimination efforts. 49 After the early adopters of treatment uptake are cured and hepatitis C becomes less prevalent, additional investment is required in outreach testing, including new approaches to enhance engagement with those who require extra support to access treatment, those who are hesitant about treatment and those who remain unaware that DAAs are available. Extra effort is required to support the affected communities, educate health care providers and simplify testing and treatment.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the cost-effectiveness of Australia's risk-sharing agreement for direct-acting antiviral treatments for hepatitis C: a modelling study

Scott

Palmer

Tidhar

et al. 2022

The Lancet Regional Health - Western Pacific

View full text Add to dashboard Cite

Summary Background Hepatitis C elimination may be possible with broad uptake of direct-acting antiviral treatments (DAAs). In 2016 the Australian government committed A$1.2 billion for five years of unlimited DAAs (March 2016 to February 2021) in a risk-sharing agreement with pharmaceutical companies. We assess the impact, cost-effectiveness and net economic benefits likely to be realised from this investment. Methods Mathematical modelling to project outcomes for 2016-2030 included: (S1) a counter-factual scenario (testing/treatment maintained at pre-2016 levels); (S2) the current status-quo (testing/treatment as actually occurred 2016-2019, with trends maintained to 2030); and (S3) elimination scenario (S2 plus testing/treatment rates increased between 2021-2030 to achieve the WHO elimination targets). Findings S1 resulted in 68,800 new hepatitis C infections and 18,540 hepatitis C-related deaths over 2016-2030. The total health system cost (HCV testing, treatment, disease management) was A$3.01 billion and the cost of lost productivity due to absenteeism, presenteeism and premature deaths was A$26.14 billion. S2 averted 15,700 (23%) new infections and 8,500 (46%) deaths by 2030, with a total health system cost of A$3.48 billion, A$472 million more than S1 (A$1.65 billion more in testing/treatment but A$1.20 billion less in disease costs; A$5,752 per QALY gained from a health systems perspective). Productivity loss over 2016-2030 was A$19.96 billion, A$6.17 less than S1, making S2 cost-saving from a societal perspective by 2022 with a net economic benefit of A$5.70 billion by 2030. S3 averted an additional 10,000 infections and 930 deaths compared with S2 and increased the longer-term economic benefit. Interpretation Five years of unrestricted access to DAAs in Australia has led to significant health benefits and is likely to become cost-saving from a societal perspective by 2022. Funding Burnet Institute

show abstract

“… 18 Recent declines in testing and treatment numbers indicate that existing care models may not be meeting the needs of all PWID, particularly compared with populations already treated. 19 Along with disproportionate levels of unemployment, poverty, homelessness and criminalisation, 20–22 PWID also experience compounded structural barriers to HCV care, including difficulties navigating health systems, 23–25 and the experience of discrimination when accessing health services. 26 Taken together, the multiple and complex barriers to HCV care experienced by PWID can impede the initiation of, and retention in, HCV care.…”

Section: Introductionmentioning

confidence: 99%

Exploring hepatitis C virus testing and treatment engagement over time in Melbourne, Australia: a study protocol for a longitudinal cohort study (EC-Experience Cohort study)

et al. 2022

Self Cite

View full text Add to dashboard Cite

IntroductionThe advent of direct acting antiviral therapy for hepatitis C virus (HCV) means the elimination of HCV is possible but requires sustained effort to achieve. Between 2016 and 2019, 44% of those living with HCV were treated in Australia. However, treatment uptake has declined significantly. In Australia, people who inject drugs (PWID) are the population most at risk of HCV acquisition. Eliminating HCV in Australia will require nuanced understanding of the barriers to HCV treatment experienced by PWID and tailored interventions to address these barriers. The EC-Experience Cohort study aims to explore the barriers and enablers reported by PWID to engagement in HCV care.Methods and analysisThe EC-Experience Cohort study is a prospective cohort of PWID, established in Melbourne, Australia in 2018. Participants are assigned into three study groups: (1) those not currently engaged in HCV testing; (2) those diagnosed with HCV but not currently engaged in treatment and (3) those completed treatment. Participants complete a total of four interviews every 6 months across an 18-month study period. Predictors of experience of key outcome events along the HCV care cascade will be explored over time.Ethics and disseminationEthical approval for the EC-Experience Cohort study was obtained by the Alfred Hospital Ethics Committee in Melbourne, Australia (Project Number: HREC/16/Alfred/164). All eligible participants are assessed for capacity to consent and partake in a thorough informed consent process. Results from the EC-Experience Cohort study will be disseminated via national and international scientific and public health conferences and peer-reviewed journal publications. Data from the EC-Experience Cohort study will improve the current understanding of the barriers to HCV care for PWID and guide the tailoring of service provision for specific subgroups. Understanding the barriers and how to increase engagement in care of PWID is critical to achieve HCV elimination goals.

show abstract

The phases of hepatitis C elimination: achieving WHO elimination targets

Cited by 36 publications

References 6 publications

A modelling analysis of financial incentives for hepatitis C testing and treatment uptake delivered through a community‐based testing campaign

A modelling analysis of financial incentives for hepatitis C testing and treatment uptake delivered through a community‐based testing campaign

Assessment of the cost-effectiveness of Australia's risk-sharing agreement for direct-acting antiviral treatments for hepatitis C: a modelling study

Exploring hepatitis C virus testing and treatment engagement over time in Melbourne, Australia: a study protocol for a longitudinal cohort study (EC-Experience Cohort study)

Contact Info

Product

Resources

About