Background: The access of DAA drugs makes it possible to eliminate hepatitis C virus (HCV). In 2018, DAAs were initiatively involved into outpatient insurance system in Chengdu, China, and were included in the National Reimbursement Drug List at a reduced price in 2019. The objective of this study is to predict the trend of disease burden of HCV under the Medicare Reimbursement Policy for hepatitis C in Chengdu, China.

Methods: HCV disease progression and economic burden were modeled from 2015 to 2030 in different scenarios of three intervention levels: DAA drugs are reimbursed for both out-patients and in-patients from 2019, DAAs reimbursed only for in-patients from 2020, and no any reimbursement policy as before. Historical assumptions were obtained from literature and expert interviews. The results of scenarios were compared to evaluate the impacts of the policy.

Results: Under the outpatient reimbursement policy, by 2030, the incidence of HCV in Chengdu was estimated to decrease 96% as compared to 2015 populations, the new cases of advanced liver disease were forecasted to decrease below 5. In the scenario that DAAs reimbursed only for in-patients, the number of new cases and patients with advanced liver disease were projected to reduce by 82% ~86% compared with 2015 populations. However, if no any reimbursement policy for DAAs, the number of new patients with advanced liver disease each year were forecasted to increase. Compared with the other two scenarios, the treatment costs of advanced liver disease were estimated to reduce by 22.2% and 57.0%, respectively, with the current HCV reimbursement policy in Chengdu.

Conclusions: With the current HCV reimbursement policy of involving DAAs in outpatients and inpatients medical insurance system, health and economic burden of HCV are expected to decrease in the future，and WHO target of eliminate HCV by 2030 can be achieved.