ArticleAddiction (Abingdon, England)2019
Cost-effectiveness of scaling-up HCV prevention and treatment in the United States for people who inject drugs.
Article in Addiction (Abingdon, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- A Systematic Review of Simulation Models to Track and Address the Opioid Crisis.Epidemiologic reviews · 2022Pooled it
- Sexually Transmitted Infections Treatment Guidelines, 2021.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2021Guideline
- Peer-assisted telemedicine hepatitis-C treatment for people who use drugs in rural communities: a mixed methods study.Addiction science & clinical practice · 2025Trial
- "I'm not going to lay back and watch somebody die": a qualitative study of how people who use drugs' naloxone experiences are shaped by rural risk environment and overdose education/naloxone distribution intervention.Harm reduction journal · 2023Trial
- "She Was Real About It and Made Me Feel Life Is Important": Patient Perspectives on Peers' Role in Peer-Assisted Telemedicine Hepatitis C Treatment for People Who Use Drugs in Rural Communities.Journal of addiction medicineTrial
- Informing the Equitable Implementation of Hepatitis C Interventions: Cost-Effectiveness Modeling in Rural Populations of People Who Inject Drugs.PharmacoEconomics · 2026Article
- Health and Economic Impact of Periodic Hepatitis C Virus Testing Among People Who Inject Drugs.JAMA health forum · 2025Article
- Medicaid Policy and Hepatitis C Treatment Among Rural People Who Use Drugs.Medical care · 2025Article
- Achieving Hepatitis C Micro-Elimination in Chinese Injecting Drug Users: A Dynamic Network Modeling Study.Infectious diseases and therapy · 2025Article
- Community-involved economic evaluation and development of a cost-effectiveness calculator for two peer-driven substance use interventions.Frontiers in public health · 2025Article
- Illicit Fentanyl Use and Hepatitis C Virus Seroconversion Among People Who Inject Drugs in Tijuana and San Diego: Results From a Binational Cohort Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Health-related quality of life among people who inject drugs in Australia.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2023Observational
- A multimorbidity model for estimating health outcomes from the syndemic of injection drug use and associated infections in the United States.BMC health services research · 2023Article
- A randomized controlled trial for a peer-facilitated telemedicine hepatitis c treatment intervention for people who use drugs in rural communities: study protocol for the "peer tele-HCV" study.Addiction science & clinical practice · 2023Article
- Finding undiagnosed patients with hepatitis C virus: an application of machine learning to US ambulatory electronic medical records.BMJ health & care informatics · 2023Article
- Cost of providing co-located hepatitis C treatment at a syringe service program exceeds potential reimbursement: Results from a clinical trial.Drug and alcohol dependence reports · 2022Article
- Cost-effectiveness of hepatitis C virus (HCV) elimination strategies among people who inject drugs (PWID) in Tijuana, Mexico.Addiction (Abingdon, England) · 2021Article
- County-Level Variation in Hepatitis C Virus Mortality and Trends in the United States, 2005-2017.Hepatology (Baltimore, Md.) · 2021Article
- Article
- Factors that influence enrollment in syringe services programs in rural areas: a qualitative study among program clients in Appalachian Kentucky.Harm reduction journal · 2021Article
Corrections and comments
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Authors and funding
15 authors at 8 institutions in 2 countries.
Funding
Abstract
aimsTo 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.
settingRural 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.
participantsPWID 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).
findingsFor 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.
conclusionsHepatitis 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.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.