Evidence map›Paper›PMID 37515462›Full record

ArticleAddiction (Abingdon, England)2023

Cost-effectiveness of integrated treatment for hepatitis C virus (HCV) among people who inject drugs in Norway: An economic evaluation of the INTRO-HCV trial.

Aaron Guanliang Lim, Christer Frode Aas, Ege Su Çağlar, Jørn Henrik Vold, Lars Thore Fadnes, Peter Vickerman, Kjell Arne Johansson

Abstract read
In one paragraph

Article in Addiction (Abingdon, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Clinical and demographic characteristics of participants in a hepatitis C treatment trial in rural Kentucky: How policies around treatment access may impact elimination efforts in the United States.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026
    Article
  2. Article
  3. 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

7 authors.

Aaron Guanliang LimPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.ORCID 0000-0002-3141-7496
Christer Frode AasBergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.ORCID 0000-0002-6469-9354
Ege Su ÇağlarBergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.
Jørn Henrik VoldBergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.
Lars Thore FadnesBergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.
Peter VickermanPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.ORCID 0000-0002-8291-5890
Kjell Arne JohanssonBergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.

Funding

Department of Health NIHR133208Department of Health NIHR200877Wellcome TrustWellcome Trust 220866/Z/20/Z
6 · The paper itself

Abstract

BACKGROUND AND

aimsThe INTRO-HCV randomized controlled trial conducted in Norway over 2017-2019 found that integrated treatment, compared with standard-of-care hospital treatment, for hepatitis C virus (HCV) with direct-acting antivirals (DAAs) improved treatment outcomes among people who inject drugs (PWID). We evaluated cost-effectiveness of the INTRO-HCV intervention.

designA Markov health state transition model of HCV disease progression and treatment with cost-effectiveness analysis from the health-provider perspective. Primary cost, utility, and health outcome data were derived from the trial. Costs and health benefits (quality-adjusted life-years, QALYs) were tracked over 50 years. Probabilistic and univariate sensitivity analyses investigated DAA price reductions and variations in HCV treatment and disease care cost assumptions, using costs from different countries (Norway, United Kingdom, United States, France, Australia). SETTING AND

participantsPWID attending community-based drug treatment centers for people with opioid dependence in Norway. MEASUREMENTS: Incremental cost-effectiveness ratio (ICER) in terms of cost per QALY gained, compared against a conventional (€70 000/QALY) willingness-to-pay threshold for Norway and lower (€20 000/QALY) threshold common among high-income countries.

findingsIntegrated treatment resulted in an ICER of €13 300/QALY gained, with 99% and 71% probability of being cost-effective against conventional and lower willingness-to-pay thresholds, respectively. A 30% lower DAA price reduced the ICER to €6 900/QALY gained, with 91% probability of being cost-effective at the lower willingness-to-pay threshold. A 60% and 90% lower DAA price had 36% and >99% probability of being cost-saving, respectively. Sensitivity analyses suggest integrated treatment was cost-effective at the lower willingness-to-pay threshold (>60% probability) across different assumptions on HCV treatment and disease care costs with 30% DAA price reduction, and became cost-saving with 60%-90% price reductions.

conclusionsIntegrated hepatitis C virus treatment for people who inject drugs in community settings is likely cost-effective compared with standard-of-care referral pathways in Norway and may be cost-saving in settings with particular characteristics.

Indexed as

Drug UsersHepatitis CHepatitis C, ChronicSubstance Abuse, IntravenousAntiviral AgentsCost-Benefit AnalysisHepacivirusHumansNorwayQuality-Adjusted Life YearsAntiviral Agentsdirect-acting antiviralshealth-related quality of lifeMarkov modelopiate substitution treatmentopioid agonist therapywillingness-to-pay

Identifiers

PMID37515462
PMCPMC10952903

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Registered trials

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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.