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

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  • Harold A. Pollack

    (Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan)

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.

Suggested Citation

  • Harold A. Pollack, 2001. "Cost-effectiveness of Harm Reduction in Preventing Hepatitis C among Injection Drug Users," Medical Decision Making, , vol. 21(5), pages 357-367, October.
    • Handle: RePEc:sae:medema:v:21:y:2001:i:5:p:357-367
    DOI: 10.1177/0272989X0102100502
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    References listed on IDEAS

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    1. Kaplan, Edward H. & Pollack, Harold, 1998. "Allocating HIV Prevention Resources," Socio-Economic Planning Sciences, Elsevier, vol. 32(4), pages 257-263, December.
    2. Garfein, R.S. & Vlahov, D. & Galai, N. & Doherty, M.C. & Nelson, K.E., 1996. "Viral infections in short-term injection drug users: The prevalence of the hepatitis C, hepatitis B, human immunodeficiency, and human T-lymphotropic viruses," American Journal of Public Health, American Public Health Association, vol. 86(5), pages 655-661.
    3. Hagan, H. & Des Jarlais, D.C. & Friedman, S.R. & Purchase, D. & Alter, M.J., 1995. "Reduced risk of hepatitis B and hepatitis C among injection drug users in the Tacoma syringe exchange program," American Journal of Public Health, American Public Health Association, vol. 85(11), pages 1531-1537.
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    Cited by:

    1. Packham, Analisa, 2022. "Syringe exchange programs and harm reduction: New evidence in the wake of the opioid epidemic," Journal of Public Economics, Elsevier, vol. 215(C).
    2. Ava John-Baptiste & Man Yeung & Victoria Leung & Gabrielle Velde & Murray Krahn, 2012. "Cost Effectiveness of Hepatitis C-Related Interventions Targeting Substance Users and Other High-Risk Groups," PharmacoEconomics, Springer, vol. 30(11), pages 1015-1034, November.
    3. J. P. Caulkins & G. Feichtinger & C. Gavrila & A. Greiner & J. L. Haunschmied & P. M. Kort & G. Tragler, 2006. "Dynamic Cost-Benefit Analysis of Drug Substitution Programs," Journal of Optimization Theory and Applications, Springer, vol. 128(2), pages 279-294, February.

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