{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:34:19Z","timestamp":1781224459113,"version":"3.54.1"},"reference-count":65,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,7,28]],"date-time":"2021-07-28T00:00:00Z","timestamp":1627430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100008196","name":"M\u00e9decins Sans Fronti\u00e8res","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and aims<\/jats:title><jats:p>Hepatitis C virus (HCV) treatment is essential for eliminating HCV in people who inject drugs (PWID), but has limited coverage in resource\u2010limited settings. We measured the cost\u2010effectiveness of a pilot HCV screening and treatment intervention using directly observed therapy among PWID attending harm reduction services in Nairobi, Kenya.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>We utilized an existing model of HIV and HCV transmission among current and former PWID in Nairobi to estimate the cost\u2010effectiveness of screening and treatment for HCV, including prevention benefits versus no screening and treatment. The cure rate of treatment and costs for screening and treatment were estimated from intervention data, while other model parameters were derived from literature. Cost\u2010effectiveness was evaluated over a life\u2010time horizon from the health\u2010care provider's perspective. One\u2010way and probabilistic sensitivity analyses were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Nairobi, Kenya.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>PWID.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Treatment costs, incremental cost\u2010effectiveness ratio (cost per disability\u2010adjusted life year averted).<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>The cost per disability\u2010adjusted life\u2010year averted for the intervention was $975, with 92.1% of the probabilistic sensitivity analyses simulations falling below the per capita gross domestic product for Kenya ($1509; commonly used as a suitable threshold for determining whether an intervention is cost\u2010effective). However, the intervention was not cost\u2010effective at the opportunity cost\u2010based cost\u2010effectiveness threshold of $647 per disability\u2010adjusted life\u2010year averted. Sensitivity analyses showed that the intervention could provide more value for money by including modelled estimates for HCV disease care costs, assuming lower drug prices ($75 instead of $728 per course) and excluding directly\u2010observed therapy costs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The current strategy of screening and treatment for hepatitis C virus (HCV) among people who inject drugs in Nairobi is likely to be highly cost\u2010effective with currently available cheaper drug prices, if directly\u2010observed therapy is not used and HCV disease care costs are accounted for.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.15630","type":"journal-article","created":{"date-parts":[[2021,6,29]],"date-time":"2021-06-29T09:39:06Z","timestamp":1624959546000},"page":"411-424","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["An intensive model of care for hepatitis C virus screening and treatment with direct\u2010acting antivirals in people who inject drugs in Nairobi, Kenya: a model\u2010based cost\u2010effectiveness analysis"],"prefix":"10.1111","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9775-6581","authenticated-orcid":false,"given":"Nyashadzaishe","family":"Mafirakureva","sequence":"first","affiliation":[{"name":"Population Health Sciences, Bristol Medical School University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Stone","sequence":"additional","affiliation":[{"name":"Population Health Sciences, Bristol Medical School University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4340-9995","authenticated-orcid":false,"given":"Hannah","family":"Fraser","sequence":"additional","affiliation":[{"name":"Population Health Sciences, Bristol Medical School University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"Nzomukunda","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res (MSF)  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aron","family":"Maina","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res (MSF)  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela W.","family":"Thiong'o","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res (MSF)  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kibango Walter","family":"Kizito","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res (MSF)  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther W. 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