Table 1. Direct testing, treatment, and healthcare management costs used in the modelling analyses.

This includes the unit costs of HCV screening and treatment and estimated annual costs of managing chronic HCV infection by disease progression stage. These cost estimates are used in both intervention scenarios (status quo and elimination) and for each of the economic perspectives (A, B, and C). All costs are in 2018 US dollars (US$).

Direct Costs		Without Integration	With Partial Integration	Source/Comments
Screening/Diagnostics Costs*
Ab test (each)				Costing analysis [21] from HCV treatment intervention at Machar Colony MSF-SINA clinic in Karachi, Pakistan [22,23].
	Ab-negative	US$8.38	US$5.72
	Ab-positive	US$14.92	US$10.08
PCR test (each)
	PCR-negative	US$24.21	US$14.21
	PCR-positive	US$30.97	US$20.97
Treatment Costs
Drug regimen costs
	SOF+DCV (12-week supply)	US$18.00		Pakistan Health Research Council [14]
Visit costs				MSF-SINA costing analysis [21]. Simplified treatment pathway based on algorithm implemented by hospitals in Pakistan [45]. Laboratory costs for the partial integration pathway is US$10 cheaper assuming that the RNA test kit cost is US$5 instead of US$15 as negotiated in the Egyptian HCV elimination programme [13].
	Pre-cirrhosis	US$74.30
	Post-cirrhosis	US$129.35
Laboratory costs
	Pre-cirrhosis	US$31.83	US$21.83
	Post-cirrhosis	US$38.88	US$28.88
Total treatment cost**				Sum of drug, visit, and laboratory costs.
	Pre-cirrhosis	US$124.13	US$114.13	12 weeks
	Post-cirrhosis	US$204.23	US$194.23	24 weeks
Total Costs of Diagnosis and Treatment
	Pre-cirrhosis	US$170.02	US$145.18	Costs from above for positive Ab and PCR test, plus 12 weeks of DAA treatment
	Post-cirrhosis	US$250.12	US$225.28	Costs from above for positive Ab and PCR test, plus 24 weeks of DAA treatment
Annual healthcare costs for managing HCV-related disease
	Pre-cirrhosis	US$14.80		Estimated using data from Cambodia [6] and adjusted to the Pakistan context [21] by applying WHO-CHOICE health service delivery costs for Pakistan [53].
	Compensated cirrhosis	US$46.70
	DC	US$277.60
	HCC	US$339.20

*Screening/diagnostics costs include staff time and overheads, as well as the costs of diagnostics test kits.

**Total treatment costs include visit and laboratory costs, as well as the drug regimen costs of DAA therapy (12 weeks for pre-cirrhotic patients and 24 weeks for post-cirrhotic patients).

Ab, antibody; DAA, direct-acting antiviral; DC, decompensated cirrhosis; DCV, daclatasvir; HCC, hepatocellular carcinoma; HCV, hepatitis C virus; SOF, sofosbuvir.