TY - JOUR
T1 - Estimating the Year Each State in the United States Will Achieve the World Health Organization’s Elimination Targets for Hepatitis C
AU - Sulkowski, Mark
AU - Cheng, Wei Han
AU - Marx, Steven
AU - Sanchez Gonzalez, Yuri
AU - Strezewski, John
AU - Reau, Nancy
N1 - Funding Information:
Mark Sulkowski is an employee of Johns Hopkins University School of Medicine and reports grants from AbbVie, Gilead, Janssen, and the National Institutes of Health and personal fees from AbbVie, Gilead, Janssen, and Trek. Wei-Han Cheng, Steven Marx, Yuri Sanchez Gonzalez, and John Strezewski are employees of AbbVie and may own stocks and/or stock options of the company. Nancy Reau is an employee of Rush University Medical Center and is a consultant for AbbVie, Gilead Sciences, Merck and Co, and Abbott. Her institution has received research support from Abbott, AbbVie, and Gilead Sciences.
Funding Information:
We would like to acknowledge technical support provided by Homie Razavi and Ivane Gamkrelidze, employees of Center for Disease Analysis. AbbVie provided funding for this technical support. Financial support for this study and the journal’s Rapid Service Fee was provided by AbbVie. AbbVie participated in the interpretation of data, review, and approval of the publication. All authors contributed to the development of the publication and maintained control over the final content. Medical writing services were provided by Brandy Menges of JK Associates, Inc. (a member of the Fishawack Group of Companies) and funded by AbbVie. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published. No honoraria or payments were made for authorship. AbbVie participated in the interpretation of data, review, and approval of the publication. All authors contributed to the development of the publication and maintained control over the final content. Data were presented in part at the European Association for the Study of the Liver’s Digital International Liver Congress, August 27–29, 2020 and the Digestive Disease Week (DDW) 2020 digital platform. Mark Sulkowski is an employee of Johns Hopkins University School of Medicine and reports grants from AbbVie, Gilead, Janssen, and the National Institutes of Health and personal fees from AbbVie, Gilead, Janssen, and Trek. Wei-Han Cheng, Steven Marx, Yuri Sanchez Gonzalez, and John Strezewski are employees of AbbVie and may own stocks and/or stock options of the company. Nancy Reau is an employee of Rush University Medical Center and is a consultant for AbbVie, Gilead Sciences, Merck and Co, and Abbott. Her institution has received research support from Abbott, AbbVie, and Gilead Sciences. With permission, this modeling study utilized de-identified data from two US laboratory datasets. Because the data were de-identified, no ethics committee approval was required. The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
Funding Information:
Financial support for this study and the journal’s Rapid Service Fee was provided by AbbVie. AbbVie participated in the interpretation of data, review, and approval of the publication. All authors contributed to the development of the publication and maintained control over the final content.
Publisher Copyright:
© 2020, The Author(s).
PY - 2021/1
Y1 - 2021/1
N2 - Introduction: Although hepatitis C virus (HCV) infection remains a major clinical, economic, and societal burden, the development of curative antiviral therapy may accelerate the path toward elimination. This analysis assessed the progress of United States (US) states towards achieving the World Health Organization’s (WHO) 2030 HCV elimination targets for incidence, mortality, diagnosis, and treatment. Methods: A previously published Markov model was used to simulate HCV progression over time to estimate the path to HCV elimination in each state based on prevalence, annual treatment, and diagnosis inputs from two large US laboratory datasets from January 2013 to December 2017. State-specific fibrosis stage restrictions on treatment in 2017 were included. The model estimated the year individual states would meet the WHO targets for diagnosing 90% of the HCV-infected population, treating 80% of the eligible population, reducing new HCV infections by 80%, and reducing HCV-related deaths by 65%. The minimum number of annual treatments needed between 2020 and 2030 to achieve the WHO treatment target was also calculated. Results: Overall, the USA is projected to achieve HCV elimination by 2037, with individual targets related to mortality, diagnosis, treatment, and incidence being achieved by 2020, 2027, 2033, and 2037, respectively. Three states (Connecticut, South Carolina, and Washington) are on track to meet all four elimination targets by 2030, and 18 states are not expected to meet these targets before 2040. The estimated annual number of treatments required during 2020–2030 nationally to reach the WHO treatment target is 173,514. Conclusion: With the exception of three states, the USA is not on target to meet the WHO 2030 elimination targets and 35% are off track by 10 years or more. Strategies must be implemented to reduce overall prevalence by preventing new infections, increasing rates of screening, improving linkage to care, and implementing unfettered access to curative therapy.
AB - Introduction: Although hepatitis C virus (HCV) infection remains a major clinical, economic, and societal burden, the development of curative antiviral therapy may accelerate the path toward elimination. This analysis assessed the progress of United States (US) states towards achieving the World Health Organization’s (WHO) 2030 HCV elimination targets for incidence, mortality, diagnosis, and treatment. Methods: A previously published Markov model was used to simulate HCV progression over time to estimate the path to HCV elimination in each state based on prevalence, annual treatment, and diagnosis inputs from two large US laboratory datasets from January 2013 to December 2017. State-specific fibrosis stage restrictions on treatment in 2017 were included. The model estimated the year individual states would meet the WHO targets for diagnosing 90% of the HCV-infected population, treating 80% of the eligible population, reducing new HCV infections by 80%, and reducing HCV-related deaths by 65%. The minimum number of annual treatments needed between 2020 and 2030 to achieve the WHO treatment target was also calculated. Results: Overall, the USA is projected to achieve HCV elimination by 2037, with individual targets related to mortality, diagnosis, treatment, and incidence being achieved by 2020, 2027, 2033, and 2037, respectively. Three states (Connecticut, South Carolina, and Washington) are on track to meet all four elimination targets by 2030, and 18 states are not expected to meet these targets before 2040. The estimated annual number of treatments required during 2020–2030 nationally to reach the WHO treatment target is 173,514. Conclusion: With the exception of three states, the USA is not on target to meet the WHO 2030 elimination targets and 35% are off track by 10 years or more. Strategies must be implemented to reduce overall prevalence by preventing new infections, increasing rates of screening, improving linkage to care, and implementing unfettered access to curative therapy.
KW - Elimination
KW - Epidemiology
KW - Hepatitis C
KW - Infectious disease
KW - Prevalence
UR - http://www.scopus.com/inward/record.url?scp=85094938168&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85094938168&partnerID=8YFLogxK
U2 - 10.1007/s12325-020-01535-3
DO - 10.1007/s12325-020-01535-3
M3 - Article
C2 - 33145648
AN - SCOPUS:85094938168
SN - 0741-238X
VL - 38
SP - 423
EP - 440
JO - Advances in Therapy
JF - Advances in Therapy
IS - 1
ER -