Table 2 Annual HCV–associated cost in Spain’s prisons for years 2019, 2020, 2025, 2030, 2035, 2040, 2045, and 2050 under status quo and different strategies for scaling-up treatment to all prisons.

From: Improved Health Outcomes from Hepatitis C Treatment Scale-Up in Spain’s Prisons: A Cost-Effectiveness Study

Cost Type

Strategy

2019

2020

2025

2030

2035

2040

2045

2050

Screening (€)

Status quo

7,907

5,876

6,868

2,698

2,150

1,925

1,265

802

Strategy 1

7,907

13,440

13,380

6,024

4,118

2,550

1,929

687

Strategy 2

7,907

9,658

12,295

6,641

4,564

2,782

1,532

689

Strategy 3

7,907

14,412

13,733

6,960

4,478

2,624

1,732

1,205

Strategy 4

7,907

14,695

14,814

5,821

4,302

2,236

1,730

803

Treatment (€)

Status quo

8.1 M

7.9 M

7 M

5.9 M

5.1 M

4.3 M

3.7 M

3.1 M

Strategy 1

93.1 M

91.2 M

80 M

40 M

23.3 M

13 M

8.4 M

5.8 M

Strategy 2

93 M

90.5 M

80.3 M

39.6 M

23.4 M

12.8 M

8.3 M

5.8 M

Strategy 3

315.4 M

118.4 M

67.9 M

37.8 M

22.9 M

13 M

8.3 M

5.8 M

Strategy 4

404.6 M

180.2 M

81.7 M

44.7 M

26.2 M

14.7 M

8.9 M

6.1 M

Disease management (€)

Status quo

3.7 M

3.5 M

2.8 M

2 M

1.5 M

0.9 M

0.6 M

0.4 M

Strategy 1

3.1 M

2.6 M

1.4 M

0.7 M

0.4 M

0.2 M

0.2 M

0.1 M

Strategy 2

3.2 M

2.7 M

1.4 M

0.7 M

0.4 M

0.2 M

0.2 M

0.1 M

Strategy 3

2.1 M

1.7 M

1.1 M

0.6 M

0.4 M

0.2 M

0.2 M

0.1 M

Strategy 4

1.9 M

1.5 M

0.9 M

0.5 M

0.3 M

0.2 M

0.1 M

0.1 M

Total (€)

Status quo

11.8 M

11.5 M

9.8 M

7.9 M

6.6 M

5.2 M

4.3 M

3.5 M

Strategy 1

96.2 M

93.8 M

81.4 M

40.7 M

23.7 M

13.2 M

8.5 M

5.9 M

Strategy 2

96.2 M

93.3 M

81.8 M

40.3 M

23.9 M

13 M

8.5 M

5.9 M

Strategy 3

317.5 M

120.2 M

69.1 M

38.4 M

23.4 M

13.2 M

8.4 M

5.9 M

Strategy 4

406.5 M

181.7 M

82.7 M

45.2 M

26.5 M

14.9 M

9 M

6.2 M

  1. Under status quo, 160 inmates were treated regardless of their fibrosis stages or prisons’ HCV prevalence. Strategy 1 prioritizes inmates by their fibrosis stages (fibrosis scores F4, F3, F2, F1, and F0) with a treatment capacity of 2,000/year, irrespective of the prison or region. Strategy 2 prioritizes prisons by their HCV prevalence with a treatment capacity of 2,000/year, irrespective of fibrosis stages. Strategy 3 considers unlimited capacity. In Strategies 1–3, only those sentenced with more than six months are eligible for treatment. Strategy 4 considers unlimited treatment capacity and assumed everyone, irrespective of their sentence length, is eligible for treatment.
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