ArticleThe Lancet regional health. Europe2025
Impact and cost-effectiveness of scaling up HCV testing and treatment strategies for achieving HCV elimination among people who inject drugs in England: a mathematical modelling study.
Article in The Lancet regional health. Europe, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Impact of Antiviral Therapy Scale-Up Among People Who Inject Drugs in Scotland: Regional Evidence of Hepatitis C Virus Elimination.Liver international : official journal of the International Association for the Study of the Liver · 2026Article
- From targets to real world impact: a review of models of care for chronic HBV and HCV in Europe.The Lancet regional health. Europe · 2026Review
- Estimating incidence rates of primary infection and reinfection with hepatitis C virus among people who inject drugs in Scotland: a model-based analysis of repeated cross-sectional survey data.The Lancet regional health. Europe · 2026Article
- Cost and cost-effectiveness of alternative screening and diagnostic pathways for achieving hepatitis C elimination in the country of Georgia.PLOS global public health · 2026Article
- The impact and cost-effectiveness of scaling up HCV treatment for achieving elimination among people who inject drugs in England: a synopsis including evidence synthesis and economic modelling.Health technology assessment (Winchester, England) · 2026Article
- Optimal provision of opiate substitution therapy and needle and syringe programmes: a multi-method realist evaluation.Health technology assessment (Winchester, England) · 2025Article
- A Bibliometric Analysis of the HCV Drug-Resistant Majority and Minority Variants.International journal of environmental research and public health · 2025Article
- Peer-Delivered Outreach With Rapid Treatment Pathways for Hepatitis C Testing and Treatment Among Unhoused People.Journal of viral hepatitis · 2025Article
- Cost-Effectiveness of Hepatitis C Virus Case Finding and Treatment in Eastern Europe and Central Asia.Liver international : official journal of the International Association for the Study of the Liver · 2025Article
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Authors and funding
22 authors.
Funding
Abstract
Background: England aims to reach the World Health Organization (WHO) elimination target of decreasing HCV incidence among people who inject drugs (PWID) to <2 per 100 person-years (/100pyrs) by 2030. We assessed what testing and treatment strategies will achieve this target and whether they are cost-effective. Methods: A dynamic deterministic HCV transmission model among PWID was developed for four England regions, utilising data on the scale-up of HCV treatment among PWID in prisons, drug treatment centres (DTC, where opioid agonist therapy is provided), and any other setting (e.g., primary care). The model projected whether the elimination target will be reached with existing testing and treatment initiatives ('status quo' model, SQ), or whether improvements are needed from 2024. Cost data was collated through practitioners' interviews and published literature. The mean incremental cost-effectiveness ratio (ICER per quality adjusted life year (QALY) saved, 50-year time horizon; 3.5% discount rate) of SQ (assumes counterfactual of no treatment scale-up post-2015) and improved model (counterfactual: SQ model) was compared to a willingness-to-pay threshold of £20,000/QALY saved. Findings: The SQ model projects HCV incidence will decrease by 79.7-98.6% (range of medians) over 2015-2030 to 0.2-2.2/100pyrs, with an ICER of £308-1609/QALY saved across the regions. There is >80% probability of achieving the incidence target in three regions, and 40% probability in the other region. If annual testing in DTC increases to 80% (from 27%) or 75% of people get tested during their prison stay (from 55%) from 2024 in the lower impact region, then their probability increases to >65%, with both strategies being highly cost-effective. Interpretation: Many England regions could reach the WHO HCV elimination target by 2030 under existing testing and treatment pathways. Scaling up of testing in DTC or prisons will help achieve this target and is highly cost-effective. Funding: NIHR.
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