Australia case study

As with most developed settings, in Australia people who inject drugs (PWID) are the group at highest risk of infection and transmission; however slow disease progression means that PWID do not necessarily have the heaviest burden of HCV-related liver disease.

Achieving elimination targets will involve responses among both PWID and people with advanced liver disease.

We estimated the treatment scale-up required among PWID and among people with advanced liver disease, as well as the total cost and cost-effectiveness of achieving the World Health Organization incidence and mortality targets in Australia.

We found that

  • Approximately 5,700 treatment courses per year are required for patients with advanced liver disease to achieve a 65% reduction in HCV-related mortality in Australia by 2030.
  • Approximately 4,700 treatment courses per year are required for HCV-infected people who inject drugs (59/1000 PWID) to achieve an 80% reduction in HCV incidence in Australia by 2030.
  • Achieving both targets was estimated to cost AU$4.6 ($4.2-4.9) billion over 15 years; however this was also estimated to be cost-effective, with an incremental cost-effectiveness ratio of AU$25,000 ($11,000-39,000) per quality-adjusted life year gained.

Policy briefs

The Optima HCV model is currently deployed in back-end Python code and can be run by one of our modeling specialists. A front-end version is planned for release in 2019.

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Technical reports

Eliminating Viral Hepatitis – The Investment Case: Report of the WISH Viral Hepatitis Health Forum 2018

Hellard M., Pedrana A., Howell J., Schroeder S., Scott N., Kuschel C., Wilson D.

Wish Viral Hepatitis Health Forum 2018 [PDF]

Economic evaluation of potential increased hepatitis C treatment uptake in Australia

Thein R., Hoare A., Wilson D., Krahn M., Dore G., Kwon A., Iversen J., Maher L. (2010)

National Centre in HIV Epidemiology and Clinical Research, University of New South Wales [PDF]


Modelling the elimination of hepatitis C as a public health threat in Iceland: A goal attainable by 2020

Scott N., Ólafsson S., Gottfreðsson M., Tyrfingsson T., Rúnarsdóttir V., Hansdottir I., Hernandez UB., Sigmundsdóttir G., Hellard M. (2018)

J Hepatol , 68(5), 932-939 [PDF]

Eliminating hepatitis C virus as a public health threat among HIV-positive men who have sex with men: a multi-modelling approach to understand differences in sexual risk behaviour

Scott N., Stoové M., Wilson D.P., Keiser O., El-Hayek C., Doyle J., Hellard M. (2018)

Journal of the International AIDS Society , 21(1), e25059 [PDF]

Heterogeneity in hepatitis C treatment prescribing and uptake in Australia: a geospatial analysis of a year of unrestricted treatment access

Scott N., Hainsworth S.W., Sacks-Davis R., Pedrana A., Doyle J., Wade A., Hellard M. (2018)

Journal of Virus Eradication , 4: e30–e36 [PDF]

Hepatitis C virus notification rates in Australia are highest in socioeconomically disadvantaged areas

Hainsworth S.W., Dietze P.M., Wilson D.P., Sutton B., Hellard M.E., Scott N. (2018)

PLoS One , 13(6):e0198336 [PDF]

Eliminating hepatitis C: the importance of frequent testing of people who inject drugs in high prevalence settings

Scott N., Sacks-Davis R., Pedrana A., Doyle J., Thompson A., Hellard M. (2018)

Journal of Viral Hepatitis

Reaching hepatitis C virus elimination targets requires health system interventions to enhance the care cascade

Scott N, Doyle J, Wilson DP, Wade A, Howell J, Pedrana A, Thompson A, Hellard M. (2017)

International Journal of Drug Policy , 47:107-116

Treatment scale-up to achieve global hepatitis C virus incidence and mortality elimination targets: a cost-effectiveness model

Scott N., McBryde E., Thompson A., Doyle J., Hellard M. (2017)

Gut , 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 H.J., MacLachlan J.H., Cowie B. (2017)

Australian and New Zealand Journal of Public Health , 41(2):193-198

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. (2016)

BMC Medicine , 13 (1): 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 N.K., Hickman M., Hellard M., Scott N., McBryde E., Drummer H., Vickerman P. (2016)

PloS One , 11(5), e0156213

The role of a hepatitis C virus vaccine: modelling the benefits alongside direct-acting antiviral treatments

Scott N., McBryde E., Vickerman P., Martin N., Stone J., Drummer H., Hellard M. (2015)

Journal of Gastroenterology and Hepatology , 31(4):872-882