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Modelling impact of changes in testing and treatment for HCV in Australia

Modelling impact of changes in testing and treatment for HCV in Australia. David Wilson and James Jansson. Hepatitis C infection, 2001 – 2010, by year and age group. Newly acquired hepatitis C, 2001 – 2010, by year and age group. Hepatitis C treatment. Before 2004

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Modelling impact of changes in testing and treatment for HCV in Australia

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  1. Modelling impact of changes in testing and treatment for HCV in Australia David Wilson and James Jansson

  2. Hepatitis C infection, 2001 – 2010, by year and age group

  3. Newly acquired hepatitis C, 2001 – 2010, by year and age group

  4. Hepatitis C treatment • Before 2004 • Standard interferon and ribavirin • Since 2004 • Pegylatedinterferon (PEG-IFN) and ribavirincombination • 24 or 48 weeks of weekly injections & daily oral doses • Cure rate of • 40-50% for genotype 1 (55% in Australia) • 70-80% for non-1 genotypes • Near future (PBS listed from late 2012/early 2013; increases in numbers on therapy from 2015) • IFN removed; first DAA agents (telaprevir, bocperevir) • SVR for genotype 1: 75% in 2013/2014 • SVR of 85% for all genotypes from 2015

  5. Hepatitis C cases treated • Before 2004 • 1,500-2,000 • Since 2004 • ~3,500 and steady • Future • Current treatment scenario: 3,500 treated per year • Increase scenario 1: increase to 7,000 from 2015 onwards • Increase scenario 2: increase to 10,500 from 2016 onwards • Increase scenario 3: increase to 14,000 from 2017 onwards

  6. MODEL ASSUMPTIONS • Model fitted to available epidemiological and behavioural data • Matched HCV diagnoses • Matched HCV prevalence among male/female IDUs • Non-IDU / former-IDU • 70% of cases diagnosed • Disease progression rates based on literature • Past trajectories consistentwith projections from Working Group

  7. Number of new cases of HCV per year by 2020

  8. Number of new cases of HCV per year by 2020

  9. Percentage decrease in HCV incidence in 2020

  10. Total number of people with HCV per year by 2020

  11. Percent reduction in prevalence in 2020

  12. Health economics • Using treatment cure rates for current treatments • New treatments will be even more cost-effective Cost-effective

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