The World Health Organization (WHO) has set up the elimination of hepatitis C virus (HCV) worldwide by 2030. The main aims of this study were to evaluate in HCV positive PWIDs: 1) the cost of patient’s journey of treated subjects; 2) the cost saving induced by HCV treatment for the public health system; 3) the potential cost for a national HCV elimination plan in drug users. We performed a non-interventional study including 1,333 PWIDs attending the Drug Abuse Units of the Public Health Service ASST Melegnano-Martesana (Milan, Italy), over one year (January–December 2017). The direct cost for the health services received by each patient during HCV treatment (excluding the cost of drug treatment) was collected using the electronic clinical database of the public health service.In the cohort of 1,333 patients we found 257 RNA HCV-positive PWIDs, 65 of which were treated. The mean health direct cost per each treated patient was € 1,418, while the mean the annual cost for each patient in waiting list for treatment was € 214. Considering that a HCV-positive PWID may infect within 3 years from infection at least 20 other new subjects, we may suppose that a HCV treatment may save about € 30,000 for the public health system. The study shows that HCV treatment in PWIDs can significantly reduce both individual and community health costs and that HCV elimination plans may be sustainable for the public health system by avoiding the enormous costs of the disease burden.
Keywords: HCV; Health Cost; PWIDs; DAAs; Patient’s journey
Felice Nava, Alberto Chiesa, Giovanni Strepparola, Giuseppe Pennisi, Rossano Vitali, Lucia Trevisi, Alfio Lucchini, in "MISSION" 54/2020, pp. , DOI:10.3280/mis54-2020oa10583