#VP140: Cost-Effectiveness of Pharmacy-led Versus Conventionally Delivered Antiviral Treatment for Hepatitis C in Patients Receiving Opioid Substitution Therapy: An Economic Evaluation Alongside a Pragmatic Cluster Randomised Trial

Author: Gareth Myring Will Hollingworth Hugh McLeod Lewis Beer Aaron Lim Peter Vickerman Matt Hickman John Dillon Andrew Radley

Theme: Models of Care Year: 2021

Background: In the UK, almost 90% of hepatitis C virus (HCV) infections are found in people who inject drugs (PWID). To meet World Health Organization targets for eliminating HCV as a public health problem by 2030, it is necessary to find, test, and treat these patients. Evidence shows community screening is effective at increasing uptake of testing and treatment. In a cluster randomised controlled trial, 56 pharmacies were randomly allocated to either a new pharmacist-led test and treat pathway or a conventional care pathway for patients on opioid substitution therapy (OST). Description of model of care/intervention: In the conventional care pathway, patients are referred from the pharmacy after a HCV-positive dried blood spot test to a drug treatment centre for assessment by a specialist nurse and treatment prescription (e.g. Ledipasvir with Sofosbuvir). In the new pharmacist-led pathway, all testing, assessment, and treatment for HCV occurs solely within community pharmacies. Effectiveness: A higher rate of testing (17.9% vs 10.7%, p: 0.059), treatment and sustained virologic response 12 weeks after therapy was achieved (7.2% vs 3.2%, p:

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