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Evaluating the cost‐effectiveness of existing needle and syringe programmes in preventing hepatitis C transmission in people who inject drugs.

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Title: Evaluating the cost‐effectiveness of existing needle and syringe programmes in preventing hepatitis C transmission in people who inject drugs.
Authors: Sweeney, Sedona (AUTHOR), Ward, Zoe (AUTHOR), Platt, Lucy (AUTHOR), Guinness, Lorna (AUTHOR), Hickman, Matthew (AUTHOR), Hope, Vivian (AUTHOR), Maher, Lisa (AUTHOR), Iversen, Jenny (AUTHOR), Hutchinson, Sharon J. (AUTHOR), Smith, Josie (AUTHOR), Ayres, Rachel (AUTHOR), Hainey, Ingrid (AUTHOR), Vickerman, Peter (AUTHOR)
Source: Addiction. Mar2019, Vol. 114 Issue 3, p560-570. 11p. 1 Diagram, 3 Charts, 2 Graphs.
Subjects: Hepatitis C prevention, Hepatitis C transmission, Needle exchange programs, Syringes, Attitude (Psychology), Calibration, Chronic diseases, Cost effectiveness, Insurance, Medical care costs, Medical personnel, National health services, Public health surveillance, Surveys, Disease prevalence, Quality-adjusted life years, Disease progression, Economics
Geographic Terms: Scotland, England, United Kingdom
Abstract: Aim: To evaluate the cost‐effectiveness of needle and syringe programmes (NSPs) compared with no NSPs on hepatitis C virus (HCV) transmission in the United Kingdom. Design Cost‐effectiveness analysis from a National Health Service (NHS)/health‐provider perspective, utilizing a dynamic transmission model of HCV infection and disease progression, calibrated using city‐specific surveillance and survey data, and primary data collection on NSP costs. The effectiveness of NSPs preventing HCV acquisition was based on empirical evidence. Setting and participants: UK settings with different chronic HCV prevalence among people who inject drugs (PWID): Dundee (26%), Walsall (18%) and Bristol (45%) Interventions: Current NSP provision is compared with a counterfactual scenario where NSPs are removed for 10 years and then returned to existing levels with effects collected for 40 years. Measurements HCV infections and cost per quality‐adjusted life year (QALY) gained through NSPs over 50 years. Findings Compared with a willingness‐to‐pay threshold of £20 000 per QALY gained, NSPs were highly cost‐effective over a time‐horizon of 50 years and decreased the number of HCV incident infections. The mean incremental cost‐effectiveness ratio was cost‐saving in Dundee and Bristol, and £596 per QALY gained in Walsall, with 78, 46 and 40% of simulations being cost‐saving in each city, respectively, with differences driven by coverage of NSP and HCV prevalence (lowest in Walsall). More than 90% of simulations were cost‐effective at the willingness‐to‐pay threshold. Results were robust to sensitivity analyses, including varying the time‐horizon, HCV treatment cost and numbers of HCV treatments per year. Conclusions: Needle and syringe programmes are a highly effective low‐cost intervention to reduce hepatitis C virus transmission, and in some settings they are cost‐saving. Needle and syringe programmes are likely to remain cost‐effective irrespective of changes in hepatitis C virus treatment cost and scale‐up. [ABSTRACT FROM AUTHOR]
Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Evaluating the cost‐effectiveness of existing needle and syringe programmes in preventing hepatitis C transmission in people who inject drugs.
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  Data: <searchLink fieldCode="JN" term="%22Addiction%22">Addiction</searchLink>. Mar2019, Vol. 114 Issue 3, p560-570. 11p. 1 Diagram, 3 Charts, 2 Graphs.
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  Data: <searchLink fieldCode="DE" term="%22Hepatitis+C+prevention%22">Hepatitis C prevention</searchLink><br /><searchLink fieldCode="DE" term="%22Hepatitis+C+transmission%22">Hepatitis C transmission</searchLink><br /><searchLink fieldCode="DE" term="%22Needle+exchange+programs%22">Needle exchange programs</searchLink><br /><searchLink fieldCode="DE" term="%22Syringes%22">Syringes</searchLink><br /><searchLink fieldCode="DE" term="%22Attitude+%28Psychology%29%22">Attitude (Psychology)</searchLink><br /><searchLink fieldCode="DE" term="%22Calibration%22">Calibration</searchLink><br /><searchLink fieldCode="DE" term="%22Chronic+diseases%22">Chronic diseases</searchLink><br /><searchLink fieldCode="DE" term="%22Cost+effectiveness%22">Cost effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Insurance%22">Insurance</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+care+costs%22">Medical care costs</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+personnel%22">Medical personnel</searchLink><br /><searchLink fieldCode="DE" term="%22National+health+services%22">National health services</searchLink><br /><searchLink fieldCode="DE" term="%22Public+health+surveillance%22">Public health surveillance</searchLink><br /><searchLink fieldCode="DE" term="%22Surveys%22">Surveys</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+prevalence%22">Disease prevalence</searchLink><br /><searchLink fieldCode="DE" term="%22Quality-adjusted+life+years%22">Quality-adjusted life years</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+progression%22">Disease progression</searchLink><br /><searchLink fieldCode="DE" term="%22Economics%22">Economics</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Scotland%22">Scotland</searchLink><br /><searchLink fieldCode="DE" term="%22England%22">England</searchLink><br /><searchLink fieldCode="DE" term="%22United+Kingdom%22">United Kingdom</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Aim: To evaluate the cost‐effectiveness of needle and syringe programmes (NSPs) compared with no NSPs on hepatitis C virus (HCV) transmission in the United Kingdom. Design Cost‐effectiveness analysis from a National Health Service (NHS)/health‐provider perspective, utilizing a dynamic transmission model of HCV infection and disease progression, calibrated using city‐specific surveillance and survey data, and primary data collection on NSP costs. The effectiveness of NSPs preventing HCV acquisition was based on empirical evidence. Setting and participants: UK settings with different chronic HCV prevalence among people who inject drugs (PWID): Dundee (26%), Walsall (18%) and Bristol (45%) Interventions: Current NSP provision is compared with a counterfactual scenario where NSPs are removed for 10 years and then returned to existing levels with effects collected for 40 years. Measurements HCV infections and cost per quality‐adjusted life year (QALY) gained through NSPs over 50 years. Findings Compared with a willingness‐to‐pay threshold of £20 000 per QALY gained, NSPs were highly cost‐effective over a time‐horizon of 50 years and decreased the number of HCV incident infections. The mean incremental cost‐effectiveness ratio was cost‐saving in Dundee and Bristol, and £596 per QALY gained in Walsall, with 78, 46 and 40% of simulations being cost‐saving in each city, respectively, with differences driven by coverage of NSP and HCV prevalence (lowest in Walsall). More than 90% of simulations were cost‐effective at the willingness‐to‐pay threshold. Results were robust to sensitivity analyses, including varying the time‐horizon, HCV treatment cost and numbers of HCV treatments per year. Conclusions: Needle and syringe programmes are a highly effective low‐cost intervention to reduce hepatitis C virus transmission, and in some settings they are cost‐saving. Needle and syringe programmes are likely to remain cost‐effective irrespective of changes in hepatitis C virus treatment cost and scale‐up. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1111/add.14519
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      – Code: eng
        Text: English
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        PageCount: 11
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    Subjects:
      – SubjectFull: Hepatitis C prevention
        Type: general
      – SubjectFull: Hepatitis C transmission
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      – SubjectFull: Needle exchange programs
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      – SubjectFull: Syringes
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      – SubjectFull: Attitude (Psychology)
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      – SubjectFull: Calibration
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      – SubjectFull: Chronic diseases
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      – SubjectFull: Cost effectiveness
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      – SubjectFull: Insurance
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      – SubjectFull: Medical care costs
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