PRM131 - HEPATITIS C VIRUS ELIMINATION AND ERADICATION MODELS: A SYSTEMATIC LITERATURE REVIEW

Abstract

Hepatitis C virus (HCV) elimination is an achievable goal due to highly effective direct-acting antiviral (DAA) therapies. Between 2015-2030, WHO targets globally 1) reduction in new HCV infections by 80%; 2) reduction in HCV deaths by 65%; 3) increase in HCV diagnoses from <5% to 90%; 4) increase in HCV treatment among eligible persons from <1% to 80%. The aim of this study was to systematically review the modeling approaches and results of full-economic evaluations targeting the elimination or eradication of HCV in any geographical setting. By using Scopus and OVID databases a systematic review of English-language articles published between January 2010 and October 2017 was performed, as the appearance of DAAs made the elimination or eradication of HCV a realistic goal after 2010. Data on country setting, modeling approach and results of the observed scenarios were extracted. A total of 504 articles were identified. After title/abstract and full text screening 4 studies were included into the review. These studies used dynamic economic models, compared at least four scenarios, and reported data on the treated patient numbers, total cost of the scenarios, prevalence and/or incidence reduction of HCV and mortality reduction in percentage or absolute numbers. Three of the included studies employed backward calculation to recommend strategies to reach at least one WHO HCV elimination target, the fourth study examined the impact of specific scenarios on HCV elimination and did not consider the WHO targets. Only a limited number of economic analyses were carried out to investigate the consequences of the elimination or eradication of HCV. Our findings suggest that high utilization rate of DAA therapies could help to eradicate HCV infection. However, even with unlimited number of treatment courses, interventions to improve the diagnostics and cascade of care are also required to achieve WHO HCV elimination targets.