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This study investigated the cost\u2010effectiveness of an intervention (HepCATT) to improve case\u2010finding and referral to HCV treatment compared with standard\u2010of\u2010care pathways in drug treatment centres in England.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>HCV transmission and disease progression model with cost\u2010effectiveness analysis using a health\u2010care perspective. Primary outcome and cost data from the HepCATT study parameterized the intervention, suggesting that HepCATT increased HCV testing in drug treatment centres 2.5\u2010fold and engagement onto the HCV treatment pathway 10\u2010fold. A model was used to estimate the decrease in HCV infections and HCV\u2010related deaths from 2016, with costs and health benefits (quality\u2010adjusted life\u2010years or QALYs) tracked over 50\u00a0years. Univariable and probabilistic sensitivity analyses (PSA) were undertaken.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>England\u2010specific epidemic with 40% prevalence of chronic HCV among PWID.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>PWID attending drug treatment centres.<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>Nurse facilitator in drug treatment centres to improve the HCV care pathway from HCV case\u2010finding to referral and linkage to specialist care. Comparator was the standard\u2010of\u2010care HCV care pathway.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Incremental cost\u2010effectiveness ratio (ICER) in terms of cost per QALY gained through improved case\u2010finding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Over 50\u00a0years per 1000 PWID, the HepCATT intervention could prevent 75 (95% central interval 37\u2013129) deaths and 1330 (827\u20132040) or 51% (30\u201367%) of all new infections. The mean ICER was \u00a37986 per QALY gained, with all PSA simulations being cost\u2010effective at a \u00a320\u2009000 per QALY willingness\u2010to\u2010pay threshold. Univariable sensitivity analyses suggest the intervention would become cost\u2010saving if the cost of HCV treatment reduces to \u00a33900. If scaled up to all PWID in England, the intervention would cost \u00a38.8 million and decrease incidence by 56% (33\u201370%) by 2030.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Increasing hepatitis C virus infection case\u2010finding and treatment referral in drug treatment centres could be a highly cost\u2010effective strategy for decreasing hepatitis C virus incidence among people who inject drugs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.14978","type":"journal-article","created":{"date-parts":[[2020,1,27]],"date-time":"2020-01-27T04:35:18Z","timestamp":1580099718000},"page":"1509-1521","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Cost\u2010effectiveness of the HepCATT intervention in specialist drug clinics to improve case\u2010finding and engagement with HCV treatment for people who inject drugs in England"],"prefix":"10.1111","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0268-988X","authenticated-orcid":false,"given":"Zoe","family":"Ward","sequence":"first","affiliation":[{"name":"Population Health Sciences, Bristol Medical School University of Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosie","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Population Health Sciences, Bristol Medical School University of Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Campbell","sequence":"additional","affiliation":[{"name":"Population Health Sciences, Bristol Medical School University of Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8344-1810","authenticated-orcid":false,"given":"Natasha K.","family":"Martin","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Global Public Health University of California San Diego CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham","family":"Harrison","sequence":"additional","affiliation":[{"name":"Nottingham University Hospitals NHS Trust Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7268-3168","authenticated-orcid":false,"given":"William","family":"Irving","sequence":"additional","affiliation":[{"name":"Nottingham University Hospitals NHS Trust Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9864-459X","authenticated-orcid":false,"given":"Matthew","family":"Hickman","sequence":"additional","affiliation":[{"name":"Population Health Sciences, Bristol Medical School University of Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8291-5890","authenticated-orcid":false,"given":"Peter","family":"Vickerman","sequence":"additional","affiliation":[{"name":"Population Health Sciences, Bristol Medical School University of Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,2,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-12-S2-S2"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(19)30085-8"},{"key":"e_1_2_7_4_1","volume-title":"Hepatitis C in England 2018 Report","author":"Public Health England (PHE)","year":"2018"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.antiviral.2014.01.002"},{"key":"e_1_2_7_6_1","volume-title":"Combating hepatitis B and C to reach elimination by 2030","author":"World Health Organization (WHO)","year":"2016"},{"key":"e_1_2_7_7_1","unstructured":"National Health Service (NHS) England.NHS England sets out plans to be first in the world to eliminate Hepatitis C2018. 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