OBJECTIVES: Chronic hepatitis C (CHC) treatment aims to prevent end-stage liver disease (ESLD) through sustained viral response (SVR). Treatment rates differ significantly across Europe (<1-16%). New protease-inhibitor based therapy offers an opportunity for increased SVR rates versus pegylated-interferon/ribavirin (>70% versus 50%). The analysis estimates the impact of various treatment rates on future ESLD sequelae associated with genotype-1 CHC in the UK. METHODS: A Markov model was applied to estimate disease progression of a cohort of genotype-1 CHC patients over a 20-year time horizon. Endpoints included the following ESLD states: decompensated cirrhosis (DCC), hepatocellular carcinoma (HCC), liver transplantation (LT) and liver-related death (LrD). Model structure, progression rates, CHC prevalence and disease severity at baseline were based on published economic evaluations. The number of ESLD cases averted by a 1-year increase in the current UK treatment rate (3%) to 12% and 16% was estimated for a 71.5% and 50.0% SVR rate. RESULTS:  Applying a 3% treatment rate and 71.5%/50.0% SVR rate predicted 8590/8647 cumulative DCC and 3577/3595 HCC cases, 814/820 LTs and 7613/7659 LrDs. The number of ESLD cases averted by applying a 12% treatment rate was estimated to be  565/395 DCC and 180/126 HCC cases, 51/36 LTs and 453/317 LrDs. Increasing treatment rate to 16% showed a decrease of 816/571 DCC and 260/182 HCC cases, 74/52 LTs and 655/458 LrDs. The overall reduction in ESLD cases was estimated to be -6.1%/-4.2% and -8.8%/-6.1% in both scenarios respectively. CONCLUSIONS: A 1-year increase in treatment rate was predicted to reduce the burden of genotype-1 CHC in 20 years in the UK. Different treatment rates across Europe imply unequal opportunities for patients to prevent CHC sequelae. Identifying CHC patients and offering antiviral therapy to maximise SVR could prevent substantial further severe liver disease and mortality.