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  11. A Cost-effectiveness Analysis Of A Multidisciplinary Model Of Care On Hepatitis C Care Among People Released From Provincial Prison In Quebec, Canada

A cost-effectiveness analysis of a multidisciplinary model of care on hepatitis C care among people released from provincial prison in Quebec, Canada

Charlene Weight1, Andrea Mambro1, Camille Dussault1

  • 1Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.

The International Journal on Drug Policy
|January 6, 2026

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View abstract on PubMed

Summary
This summary is machine-generated.

A new multidisciplinary care model improved hepatitis C virus (HCV) treatment outcomes for individuals released from prison. This approach proved cost-effective, offering a strong rationale for wider implementation in correctional healthcare.

Area of Science:

  • Public Health
  • Infectious Diseases
Keywords:
Cost-effectivenessHepatitis CICERModel of care

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  • Health Economics

    • Background:

    • Hepatitis C virus (HCV) infection is prevalent among individuals released from prison, often with untreated disease.
    • Barriers to community care linkage persist for this vulnerable population.
    • Standard of care (SOC) has limitations in addressing the HCV cascade within the prison-to-community transition.

    Purpose of the Study:

    • To evaluate the cost-effectiveness of a multidisciplinary care model versus SOC for HCV treatment in incarcerated individuals.
    • To assess the impact of the intervention on key steps of the HCV care cascade, including sustained virologic response (SVR).

    Main Methods:

    • A prospective, pre-post study design was employed in Quebec's largest provincial prison.
    • The intervention involved a multidisciplinary team (nurse, social worker, navigator) providing care pre-release and post-release support.
    • Outcomes measured included linkage to care, treatment initiation/completion, and SVR within 180 days post-release, analyzed from a healthcare system perspective.

    Main Results:

    • The multidisciplinary model significantly increased HCV RNA+ individuals achieving SVR (8 vs. 2).
    • Higher rates of linkage to care (16 vs. 12), treatment initiation (13 vs. 4), and treatment completion (8 vs. 2) were observed in the intervention group.
    • The incremental cost-effectiveness ratio (ICER) for achieving SVR was C$25,653 per additional patient.

    Conclusions:

    • The multidisciplinary care model effectively increased SVR rates among individuals with HCV RNA+ upon release from prison.
    • The additional cost per patient achieving SVR is marginally higher than direct-acting antiviral costs, presenting an economic justification for broader adoption.
    • This model offers a viable strategy to improve HCV outcomes in formerly incarcerated populations.
    Prison