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Providing clean injection equipment for needle and syringe programs is an extremely cost-effective way to prevent the transmission of hepatitis C (HCV) among people who inject drugs and may allow Save millions of pounds in UK infection treatment costs, according to a study conducted by the University of Bristol and the London School of Hygiene & Tropical Medicine.
Hepatitis C is a blood-borne virus that can seriously damage the liver and cause death if left untreated. More than 200,000 people are infected with HCV in the UK and more than 90% of new infections are contracted by injection drug. Needle and syringe programs provide sterile injection equipment and other prevention and support services. In the UK they are delivered by pharmacies, vans and specialized agencies.
Research, funded by the National Institute of Health Research (NHRI) and published in the journal Addiction is now the first study to evaluate the cost-effectiveness of needle and syringe programs in Western Europe.
Using data from three cities with different levels of HCV infection among injecting drug users – Bristol (45%), Dundee (26%) and Walsall (18%) – the researchers estimated the costs of existing needle and syringe programs in each city, used mathematical models to estimate their impact on the spread of HCV infection, then estimated the cost-effectiveness of programs in every city. They projected an increase in the spread of HCV if all needle and syringe programs were stopped during the first 10 years of a 50-year period (2016-2065).
In all three areas, current needle and syringe programs have resulted in reduced health care and treatment costs relative to program abandonment. Cost savings estimated at £ 159,712 in Bristol and £ 2.5 million in Dundee.
Anticipated reductions in the number of HCV infections – by 8% in Bristol and Walsall and by 40% in Dundee between 2016 and 2065 – and an improvement in the quality of life of injecting drug users. Quality-adjusted life year (QALY) earnings, a measure of saved years of life and quality of life, were 502 in Bristol, 195 in Dundee and 192 in Walsall.
The researchers also found that needle and syringe programs would continue to be cost-effective if HCV treatment rates increased or if treatment costs decreased because of their effectiveness in preventing reinfection.
Dr. Zoe Ward of the NIHR Health Protection Research Evaluation Unit at the University of Bristol and co-lead author of the study, said: "We have evaluated the impact and cost-effectiveness of needle and syringe programs in the UK Needle and syringe programs not only reduce the number of new HCV infections among injecting drug users and improve their quality of life but are also inexpensive, great value for money, and in some areas save money, which is good news for our cash-strapped local communities, we hope the Public Health Commissioners England and the local authorities will take note of and continue to put in place syringe and syringe programs, which are currently at risk of being reduced. "
In a related study of the same project, researchers found that opioid substitution therapy, such as methadone, halved the risk of HCV infection among people who inject drugs, and badociated opioid substitution therapy to syringes and needles minus a sterile needle for each injection) resulted in a 74% reduction in risk.
Sedona Sweeney, of the London School of Hygiene & Tropical Medicine, who led the economic evaluation, said: "Access to this type of data can be so important to help decision-makers make difficult decisions how to invest in public services Our results clearly indicate that needle and syringe programs are likely to be an excellent investment choice, not only in the UK but also in the UK. other parts of the world with similar levels of hepatitis C infection among people who inject drugs.
"It is imperative that countries follow the recommendations of the World Health Organization by stepping up the supply of needle and syringe programs and opioid substitution treatments." Our results provide new information. important evidence showing that this could not only reduce the number of people infected with this virus that would change lives, but could also save money for other local services, which means better health care and social services more accessible to everyone. "
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Papers:
Evaluate the cost-effectiveness of existing needle and syringe programs to prevent the transmission of hepatitis C among injecting drug users. Sedona Sweeney and Zoe Ward et al in Addiction
Impact of Current and Larger Levels of Hepatitis C Prevention and Treatment Interventions for Injection Drug Users in Three UK Contexts: What Does It Take to Achieve the Health Goals? WHO in the elimination of HCV? Zoe Ward et al. Addiction (May 2018)
Needle syringe programs and opioid substitution therapy to prevent the transmission of hepatitis C among injecting drug users. Lucy Platt et al in Cochrane Database of Systematic Reviews (September 2017)
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