[12] During this decade, simple (all oral regimens), tolerable, short-duration Neratinib (6–12 weeks) therapy with extremely high efficacy (cure rates above 90%) should become the norm for the HCV-infected population.[13, 14] The broad implementation of such therapeutic regimens has the potential to produce one of the major turnarounds in disease burden seen globally in public health and clinical medicine. However, the high cost of DAA regimens and competing public health priorities may limit

the potential impact of new HCV therapies. In this context, it is crucial to examine various treatment strategies for their capacity to limit the projected advanced liver disease burden and associated costs. This analysis explores three scenarios that incorporate different levels of treatment efficacy, eligibility, and uptake. As previously described,[15-17] country-specific inputs were used to construct a disease progression model in Microsoft Excel (Microsoft Corporation, Redmond, WA, USA) to quantify the HCV-infected population and associated costs from 2013 to 2030. Uncertainty and sensitivity analyses were completed using Crystal Ball, an Excel add-in by Oracle (Redwood Shores, CA, USA). Beta-PERT distributions were used to model uncertainty associated with

all inputs. Sensitivity http://www.selleckchem.com/products/LY294002.html analysis was used to identify the uncertainties that had the largest impact on peak prevalence in 2025. Monte-Carlo simulation was used to determine the 95% uncertainty interval for cost and prevalence. Population data were organized by sex, 5-year age groups, and year (1950–2100) and obtained from the United Nations population database.[18] In Australia, the number of people with chronic HCV (viremic population) in 2012 was estimated at 230 000[3] (Table 1). For the age and gender distribution of the infected population, notification data for hepatitis C infection (newly acquired MCE公司 and unspecified) from 1995 to 2013 were utilized to calculate age-

and gender-specific HCV detection rates by 5-year age group. The notified population was aged to the year 2013, accounting for mortality and HCV treatment–induced viral clearance. When constructing the age and gender distribution (Fig. 1), it was assumed that all people diagnosed after 2010 were alive in 2013. For other data years, it was assumed that diagnosed individuals aged ≥ 70 (1994), ≥ 75 (1996–2000), ≥ 80 (2001–2005), ≥ 85 years (2006–2010) were lost to mortality.[19] The genotype distribution of the prevalent population was estimated using data from an Australian study[20] as follows: genotype 1 (G1) = 54.5%, G2 = 5.2%, G3 = 36.8%, G4 = 1.9%, G6 = 1.6%. Age- and gender-specific transition probabilities were used to progress people annually through each disease state, as described in by earlier work.[16] Model outcomes were validated using published estimates for prevalent populations by disease state in Australia.