William Wong and post doctoral fellow Abdullah Hamadeh working at a computer

William Wong and post doctoral fellow Abdullah Hamadeh at work developing models for use in hepatitis C-related policy decisions.

Wong is one of 11 University of Waterloo researchers to receive the Ontario government Early Researcher Award.

Hepatitis C is a liver disease caused by the hepatitis C virus. People with hepatitis C often do not experience any symptoms until late in the disease’s progression. Once it reaches the chronic stage, individuals suffer from the condition for life and for many chronic hepatitis C (CHC) leads to cirrhosis and liver cancer. Early detection and treatment is key in preventing these outcomes.  

William W.L. Wong
Professor William W.L. Wong is developing a research program to examine Ontario’s hep C policies. In 2018, Ontario is set to spend at least $16,000 per patient on hepatitis C drugs over the next decade with the goal of eliminating the disease. While wider accessibility to treatment is a positive development, robust screening initiatives are also necessary as most of those infected show no symptoms.  Without screening, many CHC infections will remain undiagnosed. Thus, determining when to screen for the disease and how to improve access to treatment is essential.

Wong’s research program aims to answer these questions. His team is collecting data and developing a decision model to address two significant gaps in current hepatitis C-related policies.

“Firstly, there are no strategies to integrate screening and the ease of restrictions on treatment,” explained Wong. “Without screening chronic hepatitis C may go undetected until liver function deteriorates. This lack of detection negatively impacts the individual’s health and places an increased burden on our health system at the end stage of the disease. We need to establish a set of cost-effective and feasible integrated screening-treatment strategies to guide policy decision-making. These strategies will need to be based on health and economic consequences.”

Secondly, the team is researching a computational model that can better inform the Canadian agencies on healthcare funding than the current policy models.

“Policy modeling is the only practical option for policy decision makers to analyze the impact of screening and treatment strategies. Current policy models do not consider infectious disease dynamics and the impact of covering new CHC treatments on provincial formularies,” said Wong. “My team is collecting data and developing a new model that will assess both affordability and the impact of interventions like screening and access to treatment.”

In this research program, his lab group is collecting quantitative data gathered through interviews with CHC patients, and qualitative information from focus group discussions with CHC experts. His team will also perform evidence synthesis on the benefits and risks associated with treatment and screening.

All of this information will be used to develop a new system-level mathematical model for use in policy decision-making. The model will predict hepatitis C incidence and prevalence, the health and economic burden of the disease, and the affordability of different CHC screening and treatment strategies.

Professor William W. L. Wong

The model will be able to generate a range of outcomes including the population size of patients eligible for treatment, the expected wait times for treatment, the number of cases at different stages of CHC development, and more. It will be developed in consultation with decision-making groups like the Canadian Agency for Drugs and Technologies in Health, Health Quality Ontario, and more. The research program has earned Wong an Early Researcher Award from the Ontario government.

“The goal is to provide policy makers with a platform that will allow them to easily integrate evidence into decisions.” explained Wong. “Ultimately, we hope it will inform policy changes to make hepatitis C screening and treatment more accessible for Ontarians.”