**6. Conclusions**

In conclusion, The Netherlands appears to be on track to reach HCV elimination by 2030, though many challenges remain. This study demonstrates what it takes to meet the elimination targets in time, which might guide us in developing and implementing the (public) health policies that are needed. Dutch HCV elimination still needs invested stakeholders to maintain and, where necessary, improve the existing infrastructures regarding HCV care. These study results should be used as a base with which we can compare our actions in the future.

**Supplementary Materials:** The following are available online at https://www.mdpi.com/article/ 10.3390/jcm10194562/s1, File S1: Available treatments and SVR percentages in The Netherlands, File S2: COVID-19 scenario results, Table S1: Total number of annual HCV antiviral drug users in The Netherlands, Table S2: Approximation of the number of annual HCV antiviral drug users for HCV infection in The Netherlands, Table S3: Calculated genotype-dependant SVR percentages during the (pegylated) interferon era (2000–2014), Table S4: Status Quo scenario model inputs, Table S5: Gradual decline scenario model inputs, Table S6: Sensitivity analysis model inputs, Table S7: Twoyear COVID-19 Delay model inputs, Table S8: Post-COVID Recovery Gradual Decline model inputs, Table S9: Forecasted year of elimination with scenarios "Two-year COVID-19 Delay" and "Post-COVID Recovery Gradual Decline", Figure S1: Actual (continuous line) and predicted (dotted lines) number of patients treated with direct acting antivirals, Figure S2: Predicted number of HCV-viraemic individuals in The Netherlands over time, following the Two-year COVID-19 Delay and Post-recovery Gradual Decline scenarios, Figure S3: Predicted incident cases (cumulative) of (A) decompensated

cirrhosis, (B) hepatocellular carcinoma, and (C) liver-related mortality in The Netherlands over time, following the Two-year COVID-19 Delay and Post-recovery Gradual Decline scenarios.

**Author Contributions:** M.v.D., S.M.B., C.J.I., J.P.H.D. and R.J.d.K. were involved in the design of this study, the acquisitioning of the data, and the expert consensus meetings. M.v.D. performed the analyses. M.v.D., S.M.B. and C.J.I. interpreted the data. M.v.D. drafted the manuscript. S.M.B., C.J.I., W.-H.C., G.B., H.B., A.S.M.D., B.v.H., C.v.N., M.J.S., M.v.d.V., J.P.H.D. and R.J.d.K. revised the manuscript critically for important intellectual content. All authors have read and agreed to the published version of the manuscript.

**Funding:** This study was non-funded. The model has been provided by AbbVie and the Centre for Disease Analysis. AbbVie did not have any role in study design, data collection, management, analysis and/or interpretation. Data from the CELINE project has been used in this study. The CELINE project is supported with an unrestricted gran<sup>t</sup> from Gilead Sciences. Gilead Sciences did not have any role in study design, data collection, management, analysis and/or interpretation.

**Institutional Review Board Statement:** As data used in the development of this model were publicly available or were already collected in other, previously approved studies, ethical approval from an institutional review board was not required for the execution of this study.

**Informed Consent Statement:** Not applicable.

**Data Availability Statement:** The data presented in this study are available on request from the corresponding author.

**Acknowledgments:** We would like to thank Anouk T. Urbanus and Irene K. Veldhuijzen from the National Institute for Public Health and the Environment, and Daniela K. van Santen from the Municipal Health Services Amsterdam for their participation in expert consensus meetings and the acquisitioning of data. Furthermore, we thank Ivane Gamkrelidze for his help in calibrating the model, performing the analyses and critically revising the manuscript.

**Conflicts of Interest:** M.v.D. declares that the Radboudumc, on behalf of M.v.D., received honoraria due to participation in advisory boards of Abbvie and Gilead. S.M.B. and C.J.I. have no conflicts of interest. W.-H.C. is an employee of AbbVie and may own stocks and/or stock options of the company. J.P.H.D. declares that the Radboudumc, on behalf of J.P.H.D., received honoraria or research grants from Novartis, Ipsen, Otsuka, Abbvie, and Gilead. J.P.H.D. served as consultant for Gilead and Abbvie, and in the last two years has been member of advisory boards of Otsuka, Norgine Gilead, Bristol-Myers Squibb (B.-M.S.), Janssen, and Abbvie. R.d.K. declares that the Erasmus University Medical Centre, on behalf of R.d.K., received honoraria for consulting/speaking from Gilead, Janssen, B.-M.S., Abbvie, Merck Sharp & Dohme and Roche and received research grants from Abbvie, Gilead, GlaxoSmithKline and Janssen.
