Treatment costs of hepatitis C infection among injection drug users in Canada, 2006–2026

• Published in: The International journal of drug policy 2011-01, Vol.22 (1), p.70-76
• Main Authors: Werb, Daniel, Wood, Evan, Kerr, Thomas, Hershfield, Neil, Palmer, Robert W.H, Remis, Robert S
• Format: Article
• Language: English
• Subjects: Births; Canada; Cost; Costs; Disease transmission; Diseases; Drug use; Drug Users; Drugs; Female; Health Care Costs; Health care expenditures; Health costs; Health expenditure; Hepatitis; Hepatitis C; Hepatitis C - complications; Hepatitis C - drug therapy; Hepatitis C - economics; Hepatitis C - epidemiology; Hepatitis C virus; HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - economics; Humans; Infection; Injection drug use; Injections; Internal Medicine; Intravenous drug addicts; Male; Markov analysis; Markov Chains; Medical care; Medical Education; Medical treatment; Mortality; Ontario; Prevalence; Reproductive health; Risk; Substance Abuse, Intravenous - complications; Substance Abuse, Intravenous - economics; Substance Abuse, Intravenous - epidemiology; Treatment
• ISSN: 0955-3959; 1873-4758
• DOI: 10.1016/j.drugpo.2010.09.006

Abstract Background Canadian injection drug users (IDUs) are at high risk of hepatitis C virus infection (HCV). However, little is known about the costs associated with their HCV-related medical treatment. We estimated the medical costs of treating HCV-infected IDUs from 2006 to 2026. Methods We employed a Markov model of entry through birth or immigration to exposure-related behaviours or experiences, HCV infection, progression to HCV sequelae and mortality for active and ex-IDUs in Canada. We estimated direct and indirect treatment costs using data from the Ontario Case Costing Initiative (OCCI). Result Approximately 137,000 IDUs will suffer from HCV-related disease each year until 2026. Applying the OCCI cost data to the prevalence of HCV-related disease from 2006 to 2026 yielded an estimated cost of $3.96 billion CND to treat HCV-infected IDUs. Conclusions Substantial costs are associated with the treatment of HCV-related disease among Canadian IDUs. Given the lack of effective HCV prevention strategies in Canada, we must develop targeted evidence-based responses to prevent HCV transmission and ensure appropriate allocation of medical resources to meet the present and future treatment needs of HCV-infected IDUs.