In December 2022, NHS England reported that it was on track to eliminate hepatitis C by 2025 and attributed this to its pioneering elimination programme In just three years, the programme has found and treated 60,000 people for hepatitis C The NHS England elimination programme was developed in response to the WHO goal to eliminate hepatitis C by 2030 It responded to two critical challenges in addressing hepatitis C in England: firstly, most people with hepatitis C are unaware they have the virus, and secondly, many of those who do live with the virus face significant barriers to accessing treatment.

NHS England met these challenges with a ground-breaking commissioning model, asking pharmaceutical companies not just to set a competitive price for their drugs, but to propose strategies to find, diagnose and treat people in need of them as well The resulting ‘elimination deal’ fixed drug prices and catalysed a series of new hepatitis C education, testing and support programmes It also fostered collaboration from the outset, with the NHS, prisons, social care, the voluntary sector and the pharmaceutical industry working in partnership across England and in local areas. This report explores the development of the programme, how several of the key initiatives have worked and developed over time, and next steps in the programme It draws together publicly available reports and data on the initiatives, and data from a series of interviews undertaken with representatives from partners working on the initiatives involved The report focuses on twelve such initiatives, selected in consultation with NHS England as particularly significant elements of the programme.

The initiatives developed under the elimination programme take a wide range of approaches to reach and test people who need hepatitis C testing, and to support people who are diagnosed to access and complete treatment The work is targeted mainly through services – working in settings such as prisons, drug services and hostels which tend to engage with higher numbers of people with hepatitis C – though testing is also becoming a routine add-on in other services as well While each is distinct, the initiatives work across local systems to provide a comprehensive response to increasing hepatitis C testing and treatment,