Assessment of the cost-effectiveness of Australia's risk-sharing agreement for direct-acting antiviral treatments for hepatitis C: a modelling study

Assessment of the cost-effectiveness of Australia's risk-sharing agreement for direct-acting antiviral treatments for hepatitis C: a modelling study

Hepatitis C elimination may be possible with broad uptake of direct-acting antiviral treatments (DAAs). In 2016 the Australian government committed A$1.2 billion for five years of unlimited DAAs (March 2016 to February 2021) in a risk-sharing agreement with pharmaceutical companies. We assess the im...

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Published in:The Lancet regional health. Western Pacific Vol. 18; p. 100316
Main Authors: Scott, Dr Nick, Palmer, Ms Anna, Tidhar, Mr Tom, Stoove, Prof Mark, Sacks-Davis, Dr Rachel, Doyle, A/Prof Joseph S., Pedrana, Dr Alisa, Thompson, Prof Alexander J., Wilson, Prof David P., Hellard, Prof Margaret
Format: Journal Article
Language:English
Published: England Elsevier Ltd 01-01-2022
Elsevier
Subjects:
cost-effectiveness
elimination
hepatitis C
mathematical model
productivity
Research Paper
cost-effectiveness
GDP
productivity
DAA
hepatitis C
PWID
mathematical model
QALY
elimination
WHO
DAA, direct-acting antiviral
GDP, gross domestic product
QALY, quality-adjusted life year
PWID, people who inject drugs
WHO, World Health Organization
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Summary:Hepatitis C elimination may be possible with broad uptake of direct-acting antiviral treatments (DAAs). In 2016 the Australian government committed A$1.2 billion for five years of unlimited DAAs (March 2016 to February 2021) in a risk-sharing agreement with pharmaceutical companies. We assess the impact, cost-effectiveness and net economic benefits likely to be realised from this investment. Mathematical modelling to project outcomes for 2016-2030 included: (S1) a counter-factual scenario (testing/treatment maintained at pre-2016 levels); (S2) the current status-quo (testing/treatment as actually occurred 2016-2019, with trends maintained to 2030); and (S3) elimination scenario (S2 plus testing/treatment rates increased between 2021-2030 to achieve the WHO elimination targets). S1 resulted in 68,800 new hepatitis C infections and 18,540 hepatitis C-related deaths over 2016-2030. The total health system cost (HCV testing, treatment, disease management) was A$3.01 billion and the cost of lost productivity due to absenteeism, presenteeism and premature deaths was A$26.14 billion. S2 averted 15,700 (23%) new infections and 8,500 (46%) deaths by 2030, with a total health system cost of A$3.48 billion, A$472 million more than S1 (A$1.65 billion more in testing/treatment but A$1.20 billion less in disease costs; A$5,752 per QALY gained from a health systems perspective). Productivity loss over 2016-2030 was A$19.96 billion, A$6.17 less than S1, making S2 cost-saving from a societal perspective by 2022 with a net economic benefit of A$5.70 billion by 2030. S3 averted an additional 10,000 infections and 930 deaths compared with S2 and increased the longer-term economic benefit. Five years of unrestricted access to DAAs in Australia has led to significant health benefits and is likely to become cost-saving from a societal perspective by 2022. Burnet Institute
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ISSN:2666-6065
2666-6065
DOI:10.1016/j.lanwpc.2021.100316