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
- PMID: 38793681
- PMCID: PMC11125761
- 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
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.
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.
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- 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
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