Table 2.
Annual HCV–associated cost in Spain’s prisons for years 2019, 2020, 2025, 2030, 2035, 2040, 2045, and 2050 under status quo and different strategies for scaling-up treatment to all prisons.
| Cost Type | Strategy | 2019 | 2020 | 2025 | 2030 | 2035 | 2040 | 2045 | 2050 |
|---|---|---|---|---|---|---|---|---|---|
| Screening (€) | Status quo | 7,907 | 5,876 | 6,868 | 2,698 | 2,150 | 1,925 | 1,265 | 802 |
| Strategy 1 | 7,907 | 13,440 | 13,380 | 6,024 | 4,118 | 2,550 | 1,929 | 687 | |
| Strategy 2 | 7,907 | 9,658 | 12,295 | 6,641 | 4,564 | 2,782 | 1,532 | 689 | |
| Strategy 3 | 7,907 | 14,412 | 13,733 | 6,960 | 4,478 | 2,624 | 1,732 | 1,205 | |
| Strategy 4 | 7,907 | 14,695 | 14,814 | 5,821 | 4,302 | 2,236 | 1,730 | 803 | |
| Treatment (€) | Status quo | 8.1 M | 7.9 M | 7 M | 5.9 M | 5.1 M | 4.3 M | 3.7 M | 3.1 M |
| Strategy 1 | 93.1 M | 91.2 M | 80 M | 40 M | 23.3 M | 13 M | 8.4 M | 5.8 M | |
| Strategy 2 | 93 M | 90.5 M | 80.3 M | 39.6 M | 23.4 M | 12.8 M | 8.3 M | 5.8 M | |
| Strategy 3 | 315.4 M | 118.4 M | 67.9 M | 37.8 M | 22.9 M | 13 M | 8.3 M | 5.8 M | |
| Strategy 4 | 404.6 M | 180.2 M | 81.7 M | 44.7 M | 26.2 M | 14.7 M | 8.9 M | 6.1 M | |
| Disease management (€) | Status quo | 3.7 M | 3.5 M | 2.8 M | 2 M | 1.5 M | 0.9 M | 0.6 M | 0.4 M |
| Strategy 1 | 3.1 M | 2.6 M | 1.4 M | 0.7 M | 0.4 M | 0.2 M | 0.2 M | 0.1 M | |
| Strategy 2 | 3.2 M | 2.7 M | 1.4 M | 0.7 M | 0.4 M | 0.2 M | 0.2 M | 0.1 M | |
| Strategy 3 | 2.1 M | 1.7 M | 1.1 M | 0.6 M | 0.4 M | 0.2 M | 0.2 M | 0.1 M | |
| Strategy 4 | 1.9 M | 1.5 M | 0.9 M | 0.5 M | 0.3 M | 0.2 M | 0.1 M | 0.1 M | |
| Total (€) | Status quo | 11.8 M | 11.5 M | 9.8 M | 7.9 M | 6.6 M | 5.2 M | 4.3 M | 3.5 M |
| Strategy 1 | 96.2 M | 93.8 M | 81.4 M | 40.7 M | 23.7 M | 13.2 M | 8.5 M | 5.9 M | |
| Strategy 2 | 96.2 M | 93.3 M | 81.8 M | 40.3 M | 23.9 M | 13 M | 8.5 M | 5.9 M | |
| Strategy 3 | 317.5 M | 120.2 M | 69.1 M | 38.4 M | 23.4 M | 13.2 M | 8.4 M | 5.9 M | |
| Strategy 4 | 406.5 M | 181.7 M | 82.7 M | 45.2 M | 26.5 M | 14.9 M | 9 M | 6.2 M |
Under status quo, 160 inmates were treated regardless of their fibrosis stages or prisons’ HCV prevalence. Strategy 1 prioritizes inmates by their fibrosis stages (fibrosis scores F4, F3, F2, F1, and F0) with a treatment capacity of 2,000/year, irrespective of the prison or region. Strategy 2 prioritizes prisons by their HCV prevalence with a treatment capacity of 2,000/year, irrespective of fibrosis stages. Strategy 3 considers unlimited capacity. In Strategies 1–3, only those sentenced with more than six months are eligible for treatment. Strategy 4 considers unlimited treatment capacity and assumed everyone, irrespective of their sentence length, is eligible for treatment.