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Cost-effectiveness of scaling-up HCV prevention and treatment in the United States for people who inject drugs

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Cost-effectiveness of scaling-up HCV prevention and treatment in the United States for people who inject drugs. / Barbosa, Carolina; Fraser, Hannah; Hoerger, Thomas; Leib, Alyssa; Havens, Jennifer; Young, April; Kral, Alex H.; Page, Kimberly; Evans, Jennifer; Zibbell, Jon; Hariri, Susan; Vellozzi, Claudia; Nerlander, Lina; Ward, John; Vickerman, Peter.

In: Addiction, 02.08.2019.

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Barbosa, C, Fraser, H, Hoerger, T, Leib, A, Havens, J, Young, A, Kral, AH, Page, K, Evans, J, Zibbell, J, Hariri, S, Vellozzi, C, Nerlander, L, Ward, J & Vickerman, P 2019, 'Cost-effectiveness of scaling-up HCV prevention and treatment in the United States for people who inject drugs', Addiction. https://doi.org/10.1111/add.14731

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Barbosa, Carolina ; Fraser, Hannah ; Hoerger, Thomas ; Leib, Alyssa ; Havens, Jennifer ; Young, April ; Kral, Alex H. ; Page, Kimberly ; Evans, Jennifer ; Zibbell, Jon ; Hariri, Susan ; Vellozzi, Claudia ; Nerlander, Lina ; Ward, John ; Vickerman, Peter. / Cost-effectiveness of scaling-up HCV prevention and treatment in the United States for people who inject drugs. In: Addiction. 2019.

Bibtex

@article{40ada1e7371544d7bcc450cddb6ad995,
title = "Cost-effectiveness of scaling-up HCV prevention and treatment in the United States for people who inject drugs",
abstract = "Aims To examine the cost-effectiveness of hepatitis C virus (HCV) treatment of people who inject drugs (PWID), combined with medication-assisted treatment (MAT) and syringe-service programs (SSP), to tackle the increasing HCV epidemic in the United States. DesignHCV transmission and disease progression models with cost-effectiveness analysis using a health-care perspective. Setting Rural Perry County, KY (PC) and urban San Francisco, CA (SF), USA. Compared with PC, SF has a greater proportion of PWID with access to MAT or SSP. HCV treatment of PWID is negligible in both settings. Participants PWID data were collected between 1998 and 2015 from Social Networks Among Appalachian People, U Find Out, Urban Health Study and National HIV Behavioral Surveillance System studies. Interventions and comparator Three intervention scenarios modeled: baseline—existing SSP and MAT coverage with HCV screening and treatment with direct-acting antiviral for ex-injectors only as per standard of care; intervention 1—scale-up of SSP and MAT without changes to treatment; and intervention 2—scale-up as intervention 1 combined with HCV screening and treatment for current PWID. Measurements Incremental cost-effectiveness ratios (ICERs) and uncertainty using cost-effectiveness acceptability curves. Benefits were measured in quality-adjusted life-years (QALYs). Findings For both settings, intervention 2 is preferred to intervention 1 and the appropriate comparator for intervention 2 is the baseline scenario. Relative to baseline, for PC intervention 2 averts 1852 more HCV infections, increases QALYS by 3095, costs $21.6 million more and has an ICER of $6975/QALY. For SF, intervention 2 averts 36 473 more HCV infections, increases QALYs by 7893, costs $872 million more and has an ICER of $11 044/QALY. The cost-effectiveness of intervention 2 was robust to several sensitivity analysis. Conclusions Hepatitis C screening and treatment for people who inject drugs, combined with medication-assisted treatment and syringe-service programs, is a cost-effective strategy for reducing hepatitis C burden in the United States.",
keywords = "Hepatitis C, persons who inject drugs, opioid, modeling, cost-effectiveness analysis, medication-assisted treatment, syringe-service programs, direct-acting-antiviral HCV treatment",
author = "Carolina Barbosa and Hannah Fraser and Thomas Hoerger and Alyssa Leib and Jennifer Havens and April Young and Kral, {Alex H.} and Kimberly Page and Jennifer Evans and Jon Zibbell and Susan Hariri and Claudia Vellozzi and Lina Nerlander and John Ward and Peter Vickerman",
year = "2019",
month = "8",
day = "2",
doi = "10.1111/add.14731",
language = "English",
journal = "Addiction",
issn = "0965-2140",
publisher = "Wiley",

}

RIS - suitable for import to EndNote

TY - JOUR

T1 - Cost-effectiveness of scaling-up HCV prevention and treatment in the United States for people who inject drugs

AU - Barbosa, Carolina

AU - Fraser, Hannah

AU - Hoerger, Thomas

AU - Leib, Alyssa

AU - Havens, Jennifer

AU - Young, April

AU - Kral, Alex H.

AU - Page, Kimberly

AU - Evans, Jennifer

AU - Zibbell, Jon

AU - Hariri, Susan

AU - Vellozzi, Claudia

AU - Nerlander, Lina

AU - Ward, John

AU - Vickerman, Peter

PY - 2019/8/2

Y1 - 2019/8/2

N2 - Aims To examine the cost-effectiveness of hepatitis C virus (HCV) treatment of people who inject drugs (PWID), combined with medication-assisted treatment (MAT) and syringe-service programs (SSP), to tackle the increasing HCV epidemic in the United States. DesignHCV transmission and disease progression models with cost-effectiveness analysis using a health-care perspective. Setting Rural Perry County, KY (PC) and urban San Francisco, CA (SF), USA. Compared with PC, SF has a greater proportion of PWID with access to MAT or SSP. HCV treatment of PWID is negligible in both settings. Participants PWID data were collected between 1998 and 2015 from Social Networks Among Appalachian People, U Find Out, Urban Health Study and National HIV Behavioral Surveillance System studies. Interventions and comparator Three intervention scenarios modeled: baseline—existing SSP and MAT coverage with HCV screening and treatment with direct-acting antiviral for ex-injectors only as per standard of care; intervention 1—scale-up of SSP and MAT without changes to treatment; and intervention 2—scale-up as intervention 1 combined with HCV screening and treatment for current PWID. Measurements Incremental cost-effectiveness ratios (ICERs) and uncertainty using cost-effectiveness acceptability curves. Benefits were measured in quality-adjusted life-years (QALYs). Findings For both settings, intervention 2 is preferred to intervention 1 and the appropriate comparator for intervention 2 is the baseline scenario. Relative to baseline, for PC intervention 2 averts 1852 more HCV infections, increases QALYS by 3095, costs $21.6 million more and has an ICER of $6975/QALY. For SF, intervention 2 averts 36 473 more HCV infections, increases QALYs by 7893, costs $872 million more and has an ICER of $11 044/QALY. The cost-effectiveness of intervention 2 was robust to several sensitivity analysis. Conclusions Hepatitis C screening and treatment for people who inject drugs, combined with medication-assisted treatment and syringe-service programs, is a cost-effective strategy for reducing hepatitis C burden in the United States.

AB - Aims To examine the cost-effectiveness of hepatitis C virus (HCV) treatment of people who inject drugs (PWID), combined with medication-assisted treatment (MAT) and syringe-service programs (SSP), to tackle the increasing HCV epidemic in the United States. DesignHCV transmission and disease progression models with cost-effectiveness analysis using a health-care perspective. Setting Rural Perry County, KY (PC) and urban San Francisco, CA (SF), USA. Compared with PC, SF has a greater proportion of PWID with access to MAT or SSP. HCV treatment of PWID is negligible in both settings. Participants PWID data were collected between 1998 and 2015 from Social Networks Among Appalachian People, U Find Out, Urban Health Study and National HIV Behavioral Surveillance System studies. Interventions and comparator Three intervention scenarios modeled: baseline—existing SSP and MAT coverage with HCV screening and treatment with direct-acting antiviral for ex-injectors only as per standard of care; intervention 1—scale-up of SSP and MAT without changes to treatment; and intervention 2—scale-up as intervention 1 combined with HCV screening and treatment for current PWID. Measurements Incremental cost-effectiveness ratios (ICERs) and uncertainty using cost-effectiveness acceptability curves. Benefits were measured in quality-adjusted life-years (QALYs). Findings For both settings, intervention 2 is preferred to intervention 1 and the appropriate comparator for intervention 2 is the baseline scenario. Relative to baseline, for PC intervention 2 averts 1852 more HCV infections, increases QALYS by 3095, costs $21.6 million more and has an ICER of $6975/QALY. For SF, intervention 2 averts 36 473 more HCV infections, increases QALYs by 7893, costs $872 million more and has an ICER of $11 044/QALY. The cost-effectiveness of intervention 2 was robust to several sensitivity analysis. Conclusions Hepatitis C screening and treatment for people who inject drugs, combined with medication-assisted treatment and syringe-service programs, is a cost-effective strategy for reducing hepatitis C burden in the United States.

KW - Hepatitis C

KW - persons who inject drugs

KW - opioid, modeling

KW - cost-effectiveness analysis, medication-assisted treatment

KW - syringe-service programs

KW - direct-acting-antiviral HCV treatment

U2 - 10.1111/add.14731

DO - 10.1111/add.14731

M3 - Article

JO - Addiction

JF - Addiction

SN - 0965-2140

ER -