Scaling up strategies to eliminate HCV could save 90,000 lives, $60 billion by 2050

November 16, 2022

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Source/information

Source:

Chhatwal J. National HCV elimination program for the United States: Modeling health benefits and costs. Presented at: The Liver Meeting; Nov. 4-8, 2022; Washington (hybrid).

Disclosures:
Chhatwal reports participation in advisory boards or review boards for Gilead Sciences, Merck, and Novo Nordisk; consulting for Gilead Sciences; receiving grants or research support from Gilead Sciences and Merck; and hold a management position at Value Analytics Labs.


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WASHINGTON — A faster, nationally coordinated plan to eliminate the hepatitis C virus in the United States could save more than 90,000 lives and nearly $60 billion by 2050, a health economics expert told The Liver Meeting.

“In 2030, approximately 10,000 deaths can be avoided. … We expect that by 2050, this program can lead to the saving of 90,000 lives,” Jagpreet Chhatwal, PhD, director of the Institute for Technology Assessment at Massachusetts General Hospital and associate professor at Harvard Medical School, said during his presentation.


Chhatwal introduced the Hep-Sim model, which incorporates changing demographics and rising rates in different age groups; disease progression from early to late stage; therapeutic advances since 2001, including direct-acting antivirals; screening policies, which shifted from high-risk groups to universal screening; and advances in analysis. The financial model then considers the cost of treatment associated with different insurance models.

Chhatwal showed the impact of scaling up screening and treatment over the coming decades: If the United States maintained the status quo on all factors, HCV mortality would continue to decline, but not as much as if efforts were accelerated. Similarly, cases of hepatocellular carcinoma and cirrhosis could also be avoided, he said.

“A very similar story for hepatocellular carcinoma cases: By 2030, we would expect 70,000 cases to be avoided. By 2050, more than 100,000 cases will be avoided,” Chhatwal said. “Very similar to cirrhosis: By 2030, nearly 30,000 cases can be avoided. In 2050, there were 90,000 cases.”

He reminded the audience that eliminating eradication also requires more identification and testing of those individuals living with HCV: “That’s not news to people in this room, and actually we have to look at more than 3 million people.” We are trying to find them in the system in the next 5 years and then treatment is also important. On average, if you can treat about 300,000 people a year and over the next 5 years, that will help us get closer to eliminating hepatitis.”

Finally, Chhatwal showed how eliminating HCV in the US would not only save lives but also money, showing that the accelerated scenario would save $14.2 billion over the next decade, with $11.2 billion (79%) attributable to savings in Medicare or Medicaid.

“We can’t talk about eliminating hepatitis C or hep C without talking about the cost,” Chhatwal said. “The Accelerated Program can result in approximately $14 billion in savings over the next 10 years.” … This is unprecedented. We are not only eliminating disease as a public health threat, but also saving money, which is not common. It gives us a lot of drive to implement such a plan.”

Chhatwal estimated cost savings of $59.3 billion by 2050, related to the treatment and diagnosis of HCV-related diseases. He also showed that treatment costs would drop from $45.2 billion to $20.3 billion, while disease management would drop from $87 billion to $54.1 billion.

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