Implementing Prison Needle and Syringe Programs Could Offset Hepatitis C Treatment Costs

A pioneering study conducted by the Burnet Institute in Australia highlights the significant potential of prison-based needle and syringe programs (NSPs) in reducing the health and economic burden of hepatitis C. The research indicates that every dollar invested in these programs within the prison system could save more than two dollars in hepatitis C treatment costs, demonstrating a highly cost-effective public health strategy.

Hepatitis C, a serious viral infection that damages the liver, is primarily transmitted through blood-to-blood contact. Prison populations, often with a history of injecting drug use, are particularly vulnerable, making prisons critical sites for testing, prevention, and treatment efforts. Despite international endorsements of NSPs as proven, evidence-based interventions to curb the spread of blood-borne viruses, Australia currently lacks a prison NSP, even though the country leads globally in the distribution of needles and syringes outside of correctional facilities.

The recent study, titled "Return on investment for a prison-based needle and syringe program in Australia," estimates that expanding NSP coverage to reach 50% of injecting drug users across the nation's prisons would require an investment of approximately $12.2 million. Over the period from 2025 to 2030, this could prevent 894 new hepatitis C infections and 522 injection-related infections.

Implementing such a program could significantly reduce the incidence of hepatitis C, especially considering that a substantial 42% of hepatitis C treatments in Australia are administered in prisons. Dr. Farah Houdroge, senior research officer at Burnet, explained that modeling suggests prison NSPs could prevent around 30% of hepatitis C infections and 17% of injection-related infections within correctional facilities over five years.

"Introducing a prison needle and syringe program, alongside existing treatment options, could help avoid costly repeated treatments for individuals who face reinfection while incarcerated," Dr. Houdroge stated. She emphasized that this approach isn’t simply a health intervention but an intelligent investment that benefits some of Australia's most vulnerable populations.

Since the rollout of subsidized direct-acting antivirals in March 2016, Australia has seen a notable decline in chronic hepatitis C cases, including among drug users. However, the rise in infections and reinfections within prisons poses a threat to achieving the national goal of hepatitis C elimination by 2030.

Without targeted prevention strategies such as prison NSPs, progress toward this goal may be undermined. Ensuring both treatment and prevention within correctional settings is essential for reducing the disease’s burden and avoiding higher healthcare costs associated with advanced liver disease.

Overall, the evidence strongly suggests that establishing prison needle and syringe programs in Australia would be a prudent, cost-efficient move—one that can substantially curtail hepatitis C transmission, save healthcare resources, and improve health outcomes for high-risk groups.

Source: https://medicalxpress.com/news/2025-04-prison-needle-millions-hepatitis-treatment.html