Table 1.
Model Parameter Inputs and Sources
| State Transitions | HCV Stage | Mean Sampled Value (2.5%–97.5% quantiles) | Sampling Distribution | Source |
|---|---|---|---|---|
| HCV chronic prevalence among pregnant women | … | 0.73% (0.71–0.75%) | Uniform Range: 0.709–0.751 | [2] |
| HCV antibody prevalence among pregnant women | … | 1.10% (1.02–1.20%) | … | Calculated based on spontaneous clearance rate |
| Proportion who spontaneously clear their acute infection | … | 34% (30–38%) | Uniform Range: 30–38 | [9] |
| Annual loss to follow-up rates after HCV diagnosis | … | 12% (7–17%) | Uniform Range: 7–17 | [10] |
| Proportion of HCV-infected pregnant women previously diagnosed and linked to care | … | 18% (10–25%) | Uniform Range: 10–26 | [11, 12] See text |
| Background testing and linkage rate per year | … | 5% (2.6–7.4%) | Uniform Range: 2.5–7.5 | Assuming an annual testing rate of 10%/year with 50% linked to care [13] |
| HCV chronic prevalence among PWID (%) | … | 52% (44–59%) | Uniform Range: 43–60 | [14, 15] |
| Liver disease stage transition rate per year | F0 to F1 | 0.1125 (0.996–0.1261) | Beta (251.2107, 1984.813) | [16] |
| F1 to F2 | 0.1125 (0.996–0.1261) | Beta (251.2107, 1984.813) | [16] | |
| F2 to F3 | 0.1125 (0.996–0.1261) | Beta (251.2107, 1984.813) | [16] | |
| F3 to F4 | 0.1125 (0.996–0.1261) | Beta (251.2107, 1984.813) | [16] | |
| F4 to DC | 0.0406 (0.0312–0.0520) | Beta (58.49116, 1380.788) | [17–19] | |
| F4 to HCC | 0.0212 (0.0163–0.0276) | Beta (52.83443, 2417.472) | [17–19] | |
| DC to HCC | 0.0141 (0.0016–0.0395) | Beta (1.9326, 136.1074) | [17] | |
| DC/HCC to transplant | 0.0313 (0.0014–0.1077) | Beta (1.152814, 36.03474) | [17, 19, 20] | |
| Proportion who achieve SVR | … | 0.90 | Uniform Range: 0.85–0.95 | [3] |
| Liver-related death rates per year | F4 | 0.0324 (0.01716–0.05234) | Beta (12.44677, 371.1121) | [21] |
| DC | 0.2210 (0.1207–0.3414) | Beta (11.61594, 40.93614) | [21] | |
| HCC | 0.2210 (0.1207–0.3414) | Beta (11.61594, 40.93614) | [21, 22] | |
| Transplant year 1 | 0.1715 (0.1378–0.2081) | Beta (75.4499, 364.4907) | [23] | |
| Post-transplant (year 2+) | 0. 0353 (0.0288–0.0425) | Beta (97.65551, 2665.93) | [23] | |
| Annual background mortality rate | Varies by age | … | … | [2, 24] WHO lifetable, assuming age 27 at pregnancy |
| Relative risk of progression if SVR compared to no SVR | F4 to DC | 0.07 (0.03–0.2) | Lognormal (5.6356,2.43983) | [25] |
| F4 to HCC | 0.23 (0.16–0.35) | Lognormal (−3.37754,1.9534) | [25, 26] | |
| DC to HCC | 1 | - | … | |
| HCV fibrosis distribution among HCV diagnosed women | F0 | 0.16 | … | [27] |
| F1 | 0.43 | … | … | |
| F2 | 0.21 | … | … | |
| F3 | 0.10 | … | … | |
| F4 | 0.10 | … | … | |
| Cost (all costs inflated to USD 2018 [28]) | ||||
| Annual costs for non-treatment medical expenses among HCV-infected patients | F0–F3 | $511 ($304–734) | Uniform ± 50% point estimate | [29–31] |
| F4 | $2898 ($2009–3786) | Uniform ± 50% point estimate | … | |
| DC | $34 319 ($32 352–36 330) | Uniform ± 50% point estimate | … | |
| HCC | $54 741 ($49 302–60 014) | Uniform ± 50% point estimate | … | |
| Liver transplant Y1 | $225 320 ($119 270–330 260) | Uniform ± 50% point estimate | [30] | |
| Liver transplant following years | $55 196 ($28 773–81 181) | Uniform ± 50% point estimate | [30] | |
| HCV antibody test (including consultation) | … | $39 | … | [22, 32] |
| HCV RNA test (including consultation) | … | $52 | … | [22, 32] |
| Liver elastography | … | $130 | … | [22, 32] |
| HCV antiviral therapy drug cost only, per treatment course | … | $25 000 | … | [33] and glecaprevir/pibrentasvir wholesale acquisition cost |
| Treatment delivery costs per course | … | $1249 ($676–1853) | Uniform ± 50% point estimate | [3] Supplementary Table S1 |
| Health utilities | ||||
| Uninfected | … | 1 | … | [20] |
| HCV-infected patients | F0 | 0.93 (0.83–1) | Beta (59.95413, 4.512676) | [20, 34, 35] |
| F1, F2 | 0.86 (0.78–0.94) | Beta (29.92649, 4.871755) | … | |
| F3 | 0.83 (0.78–0.89) | Beta (12.30437, 2.520171) | … | |
| F4 | 0.81 (0.68–0.89) | Beta (41.6698, 9.774397) | … | |
| DC | 0.70 (0.56–0.79) | Beta (39.8121, 17.06233) | … | |
| HCC | 0.67 (0.56–0.78) | Beta (35.508, 17.48901) | … | |
| Posttransplant | 0.71 (0.69–0.79) | Beta (7.612184, 3.109202) | … | |
| Incremental increase in health utility upon SVR | … | 0.05 | … | [36] |
Abbreviations: DC, decompensated cirrhosis; F0–F4, fibrosis stages 0–4; HCC, hepatocellular carcinoma; HCV, hepatitis C virus; PWID, people who inject drugs; SVR, sustained viral response; USD, United States dollars; WHO, World Health Organization.