Cost-effectiveness of Harm Reduction in Preventing Hepatitis C among Injection Drug Users

Harold A. Pollack
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Harold A. Pollack: Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan

Medical Decision Making, 2001, vol. 21, issue 5, 357-367

Abstract: Objectives. Hepatitis C (HCV) has emerged as a major epidemic among injection drug users (IDUs), with observed prevalence exceeding 70% in many American and European cities. This article explores the potential of syringe exchange programs (SEPs) to reduce HCV incidence and prevalence. Design. A random-mixing epidemiological model is used to examine the potential impact of harm reduction interventions. Methods. Steady-state analysis is used to scrutinize the impact of SEP on HCV incidence and prevalence and to examine the accuracy of short-term incidence analysis in predicting long-run program effects. Results. SEP is predicted to have little impact on HCV incidence and prevalence within realistic populations of IDUs. Conclusions. Short-term incidence analysis substantially overstates SEP effectiveness and cost-effectiveness in preventing HCV. More comprehensive harm reduction models, coupled with referral of active IDUs to treatment, must complement syringe exchange to successfully contain highly infectious blood-borne diseases.

Keywords: harm reduction; cost-effectiveness; epidemiological models; hepatitis C; syringe and needle exchange; HIV; injection drug use (search for similar items in EconPapers)
Date: 2001
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Citations: View citations in EconPapers (3)

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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:21:y:2001:i:5:p:357-367

DOI: 10.1177/0272989X0102100502

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