Evidence map›Paper›PMID 31400755›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2020

Cost-effectiveness of Direct Antiviral Agents for Hepatitis C Virus Infection and a Combined Intervention of Syringe Access and Medication-assisted Therapy for Opioid Use Disorders in an Injection Drug Use Population.

Elizabeth R Stevens, Kimberly A Nucifora, Holly Hagan, Ashly E Jordan, Jennifer Uyei, Bilal Khan, Kirk Dombrowski, Don des Jarlais, R Scott Braithwaite

Open access · greenAbstract read
In one paragraph

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.0field-weighted citation impact, top 25% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Economic evaluation of the Hepatitis C virus elimination program in the country of Georgia, 2015 to 2017.Liver international : official journal of the International Association for the Study of the Liver · 2023
    Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Elizabeth R StevensDepartment of Population Health, New York University School of Medicine, New York, New York, USA.
Kimberly A NuciforaDepartment of Population Health, New York University School of Medicine, New York, New York, USA.
Holly HaganNew York University College of Global Public Health, New York, New York, USA.
Ashly E JordanCenter for Drug Use and Human Immunodeficiency Virus Research, New York University College of Global Public Health, New York, New York, USA.
Jennifer UyeiDepartment of Population Health, New York University School of Medicine, New York, New York, USA.
Bilal KhanDepartment of Sociology, University of Nebraska-Lincoln, Lincoln, Nebraska, USA.
Kirk DombrowskiDepartment of Sociology, University of Nebraska-Lincoln, Lincoln, Nebraska, USA.
Don des JarlaisNew York University College of Global Public Health, New York, New York, USA.
R Scott BraithwaiteDepartment of Population Health, New York University School of Medicine, New York, New York, USA.
New York University · USNew York College of Health Professions · USUniversity of Nebraska–Lincoln · US

Funding

Transdisciplinary Theoretical Svnthesis and Development CoreP30DA011041 · NIDA · NEW YORK UNIVERSITY · PI Holly Hagan, Courtney McKnight · 1998 to 2026
$38.9M
BEHAVIORAL SCI TRAINING IN DRUG ABUSE RESEARCHT32DA007233 · NIDA · PUBLIC HEALTH SOLUTIONS · PI GOLDSAMT, LLOYD A · 1985 to 2023
$20.2M
Addressing Hepatitis C and Hepatocellular Carcinoma: Current and Future EpidemicsR01DA034637 · NIDA · NEW YORK UNIVERSITY · PI HAGAN, HOLLY · 2013 to 2016
$2.5M
NIDA NIH HHS P30 DA011041NIDA NIH HHS R01 DA034637NIDA NIH HHS T32 DA007233
6 · The paper itself

Abstract

backgroundThere are too many plausible permutations and scale-up scenarios of combination hepatitis C virus (HCV) interventions for exhaustive testing in experimental trials. Therefore, we used a computer simulation to project the health and economic impacts of alternative combination intervention scenarios for people who inject drugs (PWID), focusing on direct antiviral agents (DAA) and medication-assisted treatment combined with syringe access programs (MAT+).

methodsWe performed an allocative efficiency study, using a mathematical model to simulate the progression of HCV in PWID and its related consequences. We combined 2 previously validated simulations to estimate the cost-effectiveness of intervention strategies that included a range of coverage levels. Analyses were performed from a health-sector and societal perspective, with a 15-year time horizon and a discount rate of 3%.

resultsFrom a health-sector perspective (excluding criminal justice system-related costs), 4 potential strategies fell on the cost-efficiency frontier. At 20% coverage, DAAs had an incremental cost-effectiveness ratio (ICER) of $27 251/quality-adjusted life-year (QALY). Combinations of DAA at 20% with MAT+ at 20%, 40%, and 80% coverage had ICERs of $165 985/QALY, $325 860/QALY, and $399 189/QALY, respectively. When analyzed from a societal perspective (including criminal justice system-related costs), DAA at 20% with MAT+ at 80% was the most effective intervention and was cost saving. While DAA at 20% with MAT+ at 80% was more expensive (eg, less cost saving) than MAT+ at 80% alone without DAA, it offered a favorable value compared to MAT+ at 80% alone ($23 932/QALY).

conclusionsWhen considering health-sector costs alone, DAA alone was the most cost-effective intervention. However, with criminal justice system-related costs, DAA and MAT+ implemented together became the most cost-effective intervention.

Indexed as

Antiviral AgentsHepatitis CHepatitis C, ChronicOpioid-Related DisordersPharmaceutical PreparationsSubstance Abuse, IntravenousComputer SimulationCost-Benefit AnalysisHepacivirusHumansQuality-Adjusted Life YearsSyringesAntiviral AgentsPharmaceutical Preparationscombination interventioncost-effectivenessDAAHCVPWID

Identifiers

PMID31400755
PMCPMC7286369
OpenAlexW2968195562

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.