OBJECTIVES: The registered prevalence of the hepatitis C in Russia is around 700,000 people, however it may be up to 2.3 million due to underdiagnosis. Direct-acting antivirals (DAAs) are used only in 1% of the registered patients each year. This study aims to forecast the social and economic impact of hepatitis C virus (HCV) in Russia in different scenarios of combating the disease in the future.

METHODS: Three policy scenarios were considered: "No change", maintaining the current structure of procured DAAs and procurement levels of 2020 with random patient selection for treatment; "Rational", increasing procurement funding threefold compared to 2020, prioritizing pan-genotypic drugs and patients with advanced liver disease; and "Elimination", aiming to treat all HCV-infected individuals by 2032 (and similar to the "Rational" scenario in other aspects). A comprehensive model was developed to analyze disease incidence, prevalence, and mortality. The study estimated the social impact (excess mortality, population decline, reduced life expectancy) and economic implications (treatment expenses, disability benefits, GDP impact) associated with HCV spread until 2035.

RESULTS: Between 2023 and 2035, in the "No change" scenario, HCV-related mortality is projected to reach 309,961 cases, with an estimated economic burden exceeding US$46.6 billion. The "Rational" scenario would save 124,037 lives and increase life expectancy by 0.17 years. Despite higher procurement expenses for DAAs (US$2,7 billion over the period), the overall economic effect is positive and amounts US$12.9 billion, since additional expenses are offset by the reduction in other costs and productivity losses. Implementing the "Elimination" scenario requires US$15.1 billion, doubling the impact on the number of lives saved and the increase in life expectancy compared to the "Rational" scenario. The overall positive economic effect is 28% higher, amounting to US$16.5 billion.

CONCLUSIONS: Expenditures allocated to combat HCV can be regarded as a strategic investment aimed at saving human lives and fostering economic growth.