{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:29:29Z","timestamp":1792510169738,"version":"4.5.0"},"reference-count":39,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T00:00:00Z","timestamp":1742774400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT2009408"],"award-info":[{"award-number":["GNT2009408"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000156","name":"Fonds de Recherche du Qu\u00e9bec - Sant\u00e9","doi-asserted-by":"publisher","award":["Junior 2"],"award-info":[{"award-number":["Junior 2"]}],"id":[{"id":"10.13039\/501100000156","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Journal of Australia"],"published-print":{"date-parts":[[2025,5,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To estimate and compare the costs and benefits of introducing a prison needle and syringe program in all Australian prisons.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design<\/jats:title><jats:p>Stochastic compartmental modelling study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>All Australian prisons, 1 January 2010 to 31 December 2030.<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>Introduction of a prison needle and syringe program in all Australian prisons during 1 January 2025 \u2013 1 January 2027, with the aim of covering 50% of people who inject drugs in prison by 1\u00a0January 2030.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Projected new hepatitis C virus (HCV) infections and hospitalisations with injection\u2010related bacterial and fungal infections in prisons, with and without the needle and syringe program; costs of the program; savings in treatment costs for HCV and injection\u2010related bacterial and fungal infections; benefit\u2013cost ratio of the program.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the base scenario (no prison needle and syringe program), the projected number of new HCV infections during 2025\u20132030 was 2932 (uncertainty interval [UI], 2394\u20133507) and the projected number of hospitalisations with injection\u2010related bacterial and fungal infections was 3110 (UI, 2596\u20133654). With the prison needle and syringe program, it was projected that 894 (UI\u00a0880\u2013912) new HCV infections (30%; UI, 26\u201337%) and 522 (UI,\u00a0509\u2013532) hospitalisations with injection\u2010related bacterial and fungal infections (17%; UI, 15\u201320%) would be averted; the incidence of new HCV infections would be reduced from 3.1 (UI, 2.5\u20133.7) to 1.3 (UI, 1.0\u20131.7) per 100 person\u2010years among people who inject drugs in prison. The estimated cost of the program was $12.2 million (UI,\u00a0$7.6\u201322.2 million), and the saved care costs for HCV and injection\u2010related infections were $31.7 million (UI, $29.3\u201334.6 million), yielding a benefit\u2013cost ratio of 2.6 (UI, 1.4\u20134.1). The benefit\u2013cost ratio was also greater than one for scenarios in which the assumptions and base values for several parameters were varied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Each dollar spent on a needle and syringe program in Australian prisons could save $2.60 in treatment costs for HCV and other injection\u2010related infections.<\/jats:p><\/jats:sec>","DOI":"10.5694\/mja2.52640","type":"journal-article","created":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T12:29:20Z","timestamp":1742992160000},"page":"396-402","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The costs and benefits of a prison needle and syringe program in Australia, 2025\u201330: a modelling study"],"prefix":"10.5694","volume":"222","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7614-4997","authenticated-orcid":false,"given":"Farah","family":"Houdroge","sequence":"first","affiliation":[{"name":"The Burnet Institute  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Colledge\u2010Frisby","sequence":"additional","affiliation":[{"name":"The Burnet Institute  Melbourne VIC"},{"name":"National Drug Research Institute  Perth WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadine","family":"Kronfli","sequence":"additional","affiliation":[{"name":"McGill University Health Centre  Montreal Canada"},{"name":"Centre for Outcomes Research and Evaluation Research, Institute of the McGill University Health Centre  Montreal Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2067-4278","authenticated-orcid":false,"given":"Rebecca J","family":"Winter","sequence":"additional","affiliation":[{"name":"The Burnet Institute  Melbourne VIC"},{"name":"St Vincent's Hospital Melbourne  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8043-0200","authenticated-orcid":false,"given":"Joanne","family":"Carson","sequence":"additional","affiliation":[{"name":"The Kirby Institute, University of New South Wales  Sydney NSW"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Stoove","sequence":"additional","affiliation":[{"name":"The Burnet Institute  Melbourne VIC"},{"name":"Monash University  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Scott","sequence":"additional","affiliation":[{"name":"The Burnet Institute  Melbourne VIC"},{"name":"Monash University  Melbourne VIC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,24]]},"reference":[{"key":"e_1_2_8_1_1","volume-title":"Global health\u00a0sector strategies on, respectively, HIV, viral\u00a0hepatitis and sexually transmitted\u00a0infections for the period 2022\u20132030","author":"World Health Organization","year":"2022"},{"key":"e_1_2_8_2_1","unstructured":"Australian Department of Health and Aged Care.Sixth national hepatitis C strategy 2023\u20132030[draft document].https:\/\/www.health.gov.au\/sites\/default\/files\/2023\u201005\/draft\u2010sixth\u2010national\u2010hepatitis\u2010c\u2010strategy\u20102023\u20102030\u2010for\u2010public\u2010consultation.pdf(viewed Aug 2023)."},{"key":"e_1_2_8_3_1","volume-title":"Guide to starting and managing needle and syringe programmes","author":"World Health Organization","year":"2007"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.14012"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(24)00275-5"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(23)00058-X"},{"key":"e_1_2_8_7_1","unstructured":"Australian Department of Health.Fifth national hepatitis C strategy 2018\u20132022.2018.https:\/\/www.health.gov.au\/sites\/default\/files\/documents\/2022\/06\/fifth\u2010national\u2010hepatitis\u2010c\u2010strategy\u20102018\u20102022.pdf(viewed Aug 2023)."},{"key":"e_1_2_8_8_1","volume-title":"Australia's progress towards hepatitis C elimination: annual report 2023","author":"Burnet Institute; 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