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During the first 2.5\u2009years of the program, 770\u2009832 people were screened, 48\u2009575 were diagnosed with active HCV infection, and 41\u2009483 patients were treated with direct\u2010acting antiviral (DAA)\u2010based regimens, with a &gt;95% cure rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We modelled the incremental cost\u2010effectiveness ratio (ICER) of HCV screening, diagnosis and treatment between April 2015 and November 2017 compared to no treatment, in terms of cost per quality\u2010adjusted life year (QALY) gained in 2017 US dollars, with a 3% discount rate over 25\u2009years. We compared the ICER to willingness\u2010to\u2010pay (WTP) thresholds of US$4357 (GDP) and US$871 (opportunity cost) per QALY gained.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The average cost of screening, HCV viremia testing, and treatment per patient treated was $386 to the provider, $225 to the patient and $1042 for generic DAAs. At 3% discount, 0.57 QALYs were gained per patient treated. The ICER from the perspective of the provider including generic DAAs was $2285 per QALY gained, which is cost\u2010effective at the $4357 WTP threshold, while if patient costs are included, it is just above the threshold at $4398\/QALY. All other scenarios examined in sensitivity analyses remain cost\u2010effective except for assuming a shorter time horizon to the end of 2025 or including the list price DAA cost. Reducing or excluding DAA costs reduced the ICER below the opportunity\u2010cost WTP threshold.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The Georgian HCV elimination program provides valuable evidence that national programs for scaling up HCV screening and treatment for achieving HCV elimination can be cost\u2010effective.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.15431","type":"journal-article","created":{"date-parts":[[2022,9,21]],"date-time":"2022-09-21T15:04:44Z","timestamp":1663772684000},"page":"558-568","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Economic evaluation of the Hepatitis C virus elimination program in the country of Georgia, 2015 to 2017"],"prefix":"10.1111","volume":"43","author":[{"given":"Irina","family":"Tskhomelidze","sequence":"first","affiliation":[{"name":"Task Force for Global Health  Tbilisi Georgia"},{"name":"Ivane Javakhishvili Tbilisi State 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Prevention  Atlanta USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamar","family":"Gabunia","sequence":"additional","affiliation":[{"name":"Ministry of Internally Displaced Persons from the Occupied Territories, Labour Health and Social Affairs of Georgia  Tbilisi Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amiran","family":"Gamkrelidze","sequence":"additional","affiliation":[{"name":"National Center for Disease Control and Public Health  Tbilisi Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9337-1908","authenticated-orcid":false,"given":"Vladimer","family":"Getia","sequence":"additional","affiliation":[{"name":"National Center for Disease Control and Public Health  Tbilisi Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lali","family":"Sharvadze","sequence":"additional","affiliation":[{"name":"Hepa Clinic  Tbilisi Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tengiz","family":"Tsertsvadze","sequence":"additional","affiliation":[{"name":"Infectious Diseases, AIDS and Clinical Immunology Research Center  Tbilisi Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3078-0936","authenticated-orcid":false,"given":"Jaba","family":"Zarqua","sequence":"additional","affiliation":[{"name":"Mrcheveli Clinic  Tbilisi Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shota","family":"Tsanava","sequence":"additional","affiliation":[{"name":"National Center for Disease Control and Public Health  Tbilisi Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8212-1153","authenticated-orcid":false,"given":"Senad","family":"Handanagic","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis Centers for Disease Control and Prevention  Atlanta 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