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Modelling impact of changes in testing and treatment for HCV in Australia

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Modelling impact of changes in testing and treatment for HCV in Australia. David Wilson and James Jansson. Hepatitis C infection, 2001 – 2010, by year and age group. Newly acquired hepatitis C, 2001 – 2010, by year and age group. Hepatitis C treatment. Before 2004

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Modelling impact of changes in testing and treatment for HCV in Australia

David Wilson and James Jansson

hepatitis c treatment
Hepatitis C treatment
  • Before 2004
    • Standard interferon and ribavirin
  • Since 2004
    • Pegylatedinterferon (PEG-IFN) and ribavirincombination
      • 24 or 48 weeks of weekly injections & daily oral doses
      • Cure rate of
        • 40-50% for genotype 1 (55% in Australia)
        • 70-80% for non-1 genotypes
  • Near future (PBS listed from late 2012/early 2013; increases in numbers on therapy from 2015)
    • IFN removed; first DAA agents (telaprevir, bocperevir)
    • SVR for genotype 1: 75% in 2013/2014
    • SVR of 85% for all genotypes from 2015
hepatitis c cases treated
Hepatitis C cases treated
  • Before 2004
    • 1,500-2,000
  • Since 2004
    • ~3,500 and steady
  • Future
    • Current treatment scenario: 3,500 treated per year
    • Increase scenario 1: increase to 7,000 from 2015 onwards
    • Increase scenario 2: increase to 10,500 from 2016 onwards
    • Increase scenario 3: increase to 14,000 from 2017 onwards
model assumptions
MODEL ASSUMPTIONS
  • Model fitted to available epidemiological and behavioural data
    • Matched HCV diagnoses
    • Matched HCV prevalence among male/female IDUs
    • Non-IDU / former-IDU
    • 70% of cases diagnosed
    • Disease progression rates based on literature
    • Past trajectories consistentwith projections from Working Group
health economics
Health economics
  • Using treatment cure rates for current treatments
  • New treatments will be even more cost-effective

Cost-effective

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