As the nation with the highest number of hepatitis C virus (HCV) infections globally, China stands at a critical juncture in its fight against this epidemic. New research underscores the urgent need for enhanced screening and treatment protocols to achieve the World Health Organization’s 2030 hepatitis C elimination targets.
Current Situation and Projections
A compartmental model was developed to analyze HCV transmission, disease progression, and the care cascade for China’s entire population. Utilizing data on demographics, injecting drug use, HCV prevalence, and treatments, the study evaluated five different scenarios for their potential effects and costs from 2022 to 2030. The model was calibrated and the costs were converted to 2021 US dollars, discounted at an annual rate of 5%. Sensitivity analyses ensured the robustness of the findings.
Under the status quo scenario, the incidence of hepatitis C is projected to rise from 60.39 per 100,000 person-years in 2022 to 68.72 per 100,000 person-years in 2030. The study estimates that 2.52 million infected patients will die between 2022 and 2030, with 0.76 million of these deaths directly attributable to hepatitis C. This increasing burden underscores the necessity for policy changes aimed at effective prevention and control.
Recommended Strategies
To achieve significant reductions in HCV incidence and mortality, the study suggests scaling up primary screening to 10%, implementing regular rescreening (annually for people who inject drugs and every five years for the general population), and treating 90% of diagnosed patients. This comprehensive strategy could reduce HCV incidence by 88.15% and HCV-related mortality by 60.5% by 2030, compared to 2015 levels. However, this approach would incur costs estimated at USD 52.78 billion.
Market Access Implications
The study’s findings have significant implications for market access, particularly in the healthcare sector. Scaling up screening and treatment will demand substantial financial investment and resource allocation. The projected costs, although high, present an opportunity for pharmaceutical companies to engage in public-private partnerships, potentially accelerating the availability and affordability of HCV treatments. Additionally, improved market access could facilitate the introduction of advanced diagnostic tools and therapeutic options, further enhancing the efficacy of HCV control measures.
Concrete Inferences:
– Increasing primary screening and rescreening can significantly reduce the HCV burden.
– Effective policy changes necessitate substantial financial and resource commitments.
– Collaboration with pharmaceutical companies could optimize treatment accessibility and affordability.
In conclusion, the study highlights the critical need for China to scale up its hepatitis C screening and treatment interventions to meet the WHO 2030 elimination targets. Without significant policy changes and increased investment, the burden of HCV is poised to escalate, leading to higher incidence and mortality rates.
Original Article:
Pharmacoeconomics. 2024 Sep 2. doi: 10.1007/s40273-024-01424-5. Online ahead of print.
ABSTRACT
BACKGROUND AND OBJECTIVE: China has the highest number of hepatitis C virus (HCV) infections in the world. However, it is unclear what levels of screening and treatment are needed to achieve the WHO 2030 hepatitis C elimination targets. We aimed to evaluate the impact of scaling up interventions on the hepatitis C epidemic and determine how and at what cost these elimination targets could be achieved for the whole population in China.
METHODS: We developed a compartmental model incorporating HCV transmission, disease progression, and care cascade for the whole population in China, calibrated with data on demographics, injecting drug use, HCV prevalence, and treatments. Five different scenarios were evaluated for effects and costs for 2022-2030. All costs were converted to 2021 US dollar (USD) and discounted at an annual rate of 5%. One-way sensitivity analyses were conducted to assess the robustness of the model.
RESULTS: Under the status quo scenario, the incidence of hepatitis C is projected to increase from 60.39 (57.60-63.45) per 100,000 person-years in 2022 to 68.72 (65.3-73.97) per 100,000 person-years in 2030, and 2.52 million (1.94-3.07 million) infected patients are projected to die between 2022 and 2030, of which 0.76 (0.61-1.08) million will die due to hepatitis C. By increasing primary screening to 10%, conducting regular rescreening (annually for PWID and every 5 years for the general population) and treating 90% of patients diagnosed, the incidence would be reduced by 88.15% (86.61-89.45%) and hepatitis C-related mortality by 60.5% (52.62-65.54%) by 2030, compared with 2015 levels. This strategy would cost USD 52.78 (USD 43.93-58.53) billion.
CONCLUSIONS: Without changes in HCV prevention and control policy, the disease burden of HCV in China will increase dramatically. To achieve the hepatitis C elimination targets, China needs to sufficiently scale up screening and treatment.
PMID:39222272 | DOI:10.1007/s40273-024-01424-5
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