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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

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
Hepatitis C infection, 2001 – 2010, by year and age group


Newly acquired hepatitis c 2001 2010 by year and age group
Newly acquired hepatitis C, 2001 – 2010, by year and age group


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