Table 1 Studies modelling the cost-effectiveness of antiviral therapy for hepatitis C virus infection in people who inject drugs (PWID)

Martin et al. 2012 [70]

United Kingdom

Dynamic disease progression and transmission model

pegIFN/RBV at mild stage vs no treatment (best supportive care) in:

ICER for treating current PWID vs no treatment, according to baseline chronic HCV prevalence:

Probablistic cost-utility analysis

Current PWID

20 % prevalence: ICER treat PWID vs no treatment = £521/QALY

Direct medical costs (2010 prices)

Non/ex PWID

40 % prevalence: ICER vs no treatment = £2539/QALY

N = 1000 individuals

60 % prevalence: ICER = £7675^a/QALY

Treatment of non/ex-PWID dominant at 60 % prevalence; ICER £6803/QALY vs no treatment

Visconti et al. 2013 [71]

Australia

Markov decision-analytic model

pegIFN/RBV at mild (F0/1) stage vs no treatment (best supportive care) in:

Current PWID: $AUS 7941/QALY

Direct medical costs (2011 prices)

Current PWID

Former PWID: $AUS 5808/QALY

Former PWID

Non-injectors: $AUS 3985/QALY

Non-injectors

Treatment at mild stage dominated treatment at later stages for all cohorts

N = 1000 individuals

DAA therapy

Bennett et al. 2015 [58]

United Kingdom

Dynamic model of disease progression, transmission and treatment

Uptake increased to 250 per 1000 PWID of:

2015–2027

Current treatment

Current treatment: £23.4 million saved (£5.4 after discounting)

New DAA (SVR90%)

SVR90%: £36.3 million saved (£8.4 million after discounting)

Lifetime complication rates, costs of complications

N = 4240 individuals

Hellard et al. 2015 [72]

Australia

Closed compartmental model of disease progression and treatment

IFN-free DAA at

Late treatment vs no treatment: $AUS5078

Early stage (from F0)

Early treatment vs late treatment: $AUS17,090

Fixed rate of re-infection

Late-stage (from F2/3)

Direct healthcare costs (2014 prices)

N = 1000 individuals

Scott et al. 2016 [73]

Australia

Open compartmental model of progression, transmission and treatment

DAA treatment scale up necessary to achieve WHO goals of 65 % reduction in HCV-related deaths and 80 % reduction in HCV incidence by 2030 via two scenarios if DAA treatment for IDU-acquired HCV prioritised to: Patients with advanced liver disease (F ≥ 3) or Current PWID

Prioritising advanced liver disease: Mortality target required 5662 (95 % CI 5202–6901) courses/year (30/1000 IDU-acquired infections)

Prioritising PWID:

Incidence and mortality targets achieved with 4725 (95 % CI 3278–8420) courses per year (59/1000 PWID)

Additional 5564 (1959–6917) treatments/year (30/1000 IDU-acquired infections) required for 5 years for patients with advanced liver disease to avoid excess HCV-related deaths

ICER: $AUS25,121 ($AUS11,062–$AUS39,036)/QALY