The advent of highly effective direct-acting antiviral therapies for the treatment of the Hepatitis C Virus (HCV) means that elimination is now firmly on the agenda, with the World Health Organization recently announcing elimination targets including:
- A 65 percent reduction in HCV-related deaths by the year 2030
- An 80 percent reduction in HCV incidence by the year 2030.
Image: HCV related liver disease among current and former PWID in Australia: project outcomes 2015-2030 under different treatment scenarios.
We are aiming to answer the following questions in a range of settings:
- How do we determine the most cost-effective scale-up of treatments among priority groups, through different modalities, and over different time-frames?
- How much will it cost to reach strategic targets?
- How can the cascade of care be optimised to maximise the number of people receiving curative treatment?
- Where are the bottlenecks?
- Which modalities of which programs are required (e.g. mobile clinics or nurse-led models of care)?
Given the limited resources available, we will investigate what the best use of funding across the programs of prevention, testing and treatment might be to:
- Minimise morbidity and mortality
- Minimise new infections
- Get as close as possible to multiple national targets.
- Reaching hepatitis C virus elimination targets requires health system interventions to enhance the care cascade.
Scott N, Doyle JS, Wilson DP, Wade A, Howell J, Pedrana A, Thompson A, Hellard ME
Int J Drug Policy. 2017 Aug; Epub ahead of print
- Treatment scale-up to achieve global HCV incidence and mortality elimination targets: a cost-effectiveness model.
Scott N, McBryde ES, Thompson A, Doyle JS, Hellard ME
Gut. 2017 Mar; 66(8):1507-1515
- Limited provision of diagnostic services to Victorians living with hepatitis C antibodies, 2001-2012: a multi-level modelling analysis.
Snow K, Scott N, Clothier HJ, MacLachlan JH, Cowie B
Aust N Z J Public Health. 2017 Feb; 41(2):193-198
- The Potential Impact of a Hepatitis C Vaccine for People Who Inject Drugs: Is a Vaccine Needed in the Age of Direct-Acting Antivirals?
Stone J, Martin NK, Hickman M, Hellard M, Scott N, McBryde E, Drummer H, Vickerman P
PLoS One. 2016 May; 11(5):e0156213
- Cost-effectiveness of treating chronic hepatitis C virus with direct-acting antivirals in people who inject drugs in Australia.
Scott N, Iser D, Thompson A, Doyle J, Hellard M
J Gastroenterol Hepatol. 2016 Feb; 31(4):872-882
- Modelling hepatitis C virus transmission among people who inject drugs: assumptions, limitations and future challenges.
Scott N, Hellard M, McBryde E
Virulence. 2016 Feb; 7(2):201-208