Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May 17;16(5):800.
doi: 10.3390/v16050800.

Evaluation of a Project Integrating Financial Incentives into a Hepatitis C Testing and Treatment Model of Care at a Sexual Health Service in Cairns, Australia, 2020-2021

Affiliations

Evaluation of a Project Integrating Financial Incentives into a Hepatitis C Testing and Treatment Model of Care at a Sexual Health Service in Cairns, Australia, 2020-2021

Joshua Dawe et al. Viruses. .

Abstract

Background: Understanding the effectiveness of novel models of care in community-based settings is critical to achieving hepatitis C elimination. We conducted an evaluation of a hepatitis C model of care with financial incentives that aimed to improve engagement across the hepatitis C cascade of care at a sexual health service in Cairns, Australia.

Methods: Between March 2020 and May 2021, financial incentives were embedded into an established person-centred hepatitis C model of care at Cairns Sexual Health Service. Clients of the Service who self-reported experiences of injecting drugs were offered an AUD 20 cash incentive for hepatitis C testing, treatment initiation, treatment completion, and test for cure. Descriptive statistics were used to describe retention in hepatitis C care in the incentivised model. They were compared to the standard of care offered in the 11 months prior to intervention.

Results: A total of 121 clients received financial incentives for hepatitis C testing (antibody or RNA). Twenty-eight clients were hepatitis C RNA positive, of whom 92% (24/28) commenced treatment, 75% (21/28) completed treatment, and 68% (19/28) achieved a sustained virological response (SVR). There were improvements in the proportion of clients diagnosed with hepatitis C who commenced treatment (86% vs. 75%), completed treatment (75% vs. 40%), and achieved SVR (68% vs. 17%) compared to the pre-intervention comparison period.

Conclusions: In this study, financial incentives improved engagement and retention in hepatitis C care for people who inject drugs in a model of care that incorporated a person-centred and flexible approach.

Keywords: financial incentives; hepatitis C; people who inject drugs; primary care.

PubMed Disclaimer

Conflict of interest statement

Joe Doyle’s institution has received investigator-initiated research funding from Gilead Science, AbbVie, Merck and Bristol Myers Squibb, and consultancy funding from Gilead, Abbvie, and Merck. Alisa Pedrana’s institution has received investigator-initiated research funding from Gilead Science, AbbVie, Merck has consultancy and speaker fees from Gilead. All other authors have no competing interests.

Figures

Figure 1
Figure 1
Flow diagram describing Cairns Sexual Health Service model of care with incentive payments a. a Shaded boxes represent the points at which financial incentives were offered.
Figure 2
Figure 2
Hepatitis C cascade of care among people who received a financial incentive for hepatitis C testing at the Cairns Sexual Health Service a, (N = 121). a Number of people in the previous stage of cascade of care is denominator in percentages. b Number of clients who received a hepatitis C test (antibody or RNA). c Fifty-four clients were known to be hepatitis C antibody positive and initially received a hepatitis C RNA test.
Figure 3
Figure 3
Comparison of hepatitis C treatment outcomes among clients who received a positive hepatitis C RNA test before and after the introduction of financial incentives a,b, (n = 46). a Number of clients diagnosed with chronic hepatitis C is denominator in percentages. b Bars represent 95% confidence intervals for proportions.

References

    1. The Pharmaceutical Benefits Scheme November 2015—Positive Recommendations (2015) Meetings, Australian Government Department of Health and Aged Care. [(accessed on 30 June 2023)]; Available online: https://www.pbs.gov.au/pbs/industry/listing/elements/pbac-meetings/pbac-....
    1. Kirby Institute Monitoring Hepatitis C Treatment Uptake in Australia (Issue 11) 2021. [(accessed on 30 June 2023)]. Available online: https://kirby.unsw.edu.au/report/monitoring-hepatitis-c-treatment-uptake....
    1. Kirby Institute. HIV, Viral Hepatitis and Sexually Transmissible Infections in Australia: Annual Surveillance Report 2021. 2021. [(accessed on 30 June 2023)]. Report, Kirby Institute. Available online: https://www.kirby.unsw.edu.au/research/reports/asr2021.
    1. Doyle J.S., Scott N., Sacks-Davis R., Pedrana A.E., Thompson A.J., Hellard M.E., Eliminate Hepatitis CPartnership Hellard M., Thompson A., Doyle J., Dietze P. Treatment access is only the first step to hepatitis C elimination: Experience of universal anti-viral treatment access in Australia. Aliment. Pharmacol. Ther. 2019;49:1223–1229. doi: 10.1111/apt.15210. - DOI - PubMed
    1. Scott N., Sacks-Davis R., Wade A.J., Stoove M., Pedrana A., Doyle J.S., Thompson A.J., Wilson D.P., Hellard M.E. Australia needs to increase testing to achieve hepatitis C elimination. Med. J. Aust. 2020;212:365–370. doi: 10.5694/mja2.50544. - DOI - PMC - PubMed

Substances

Grants and funding