Objective: To evaluate the impact of incorporating direct antiviral drugs into the "dual channel" model on the medical insurance budget，patient burden and external costs. Methods: Dynamic transmission pathways and Markov models were constructed to measure the external cost savings from avoided transmission in the "dual channel" model. Results: Under the "dual channel" model of direct antiviral drugs，the increase in annual health insurance expenditure were 39.92 million yuan60.05 million yuan and 93.07 million yuan respectively under individual payment，with the per capita burden of patients reduced by 3，887 yuan/year; under the fixed payment by disease type，the increase in annual health insurance expenditure were 46.26 million yuan75.16 million yuan and 107 million yuan respectively，with the per capita burden of patients reduced by 4582 yuan/year. Under the outpatient referral hospitalization payment，the incremental health insurance expenditure were 51.35 million yuan83 million yuan and 118 million yuan respectively，and the per capita burden of patients was reduced by 5120 yuan/year. The savings in external medical costs under the "dual channel" model were 3.13 million yuan7.42 million yuan and 12.26 million yuan in each year. Conclusion: Each payment mode of "dual channel" mode increases the medical insurance expenditure to varying degrees，reduces the burden of patients and saves external costs for the society.