New hep C therapies: Worth the cost?

New direct-acting hepatitis C antiviral therapies boast the potential for cure rates as high as 90% in patients with the notoriously hard-to-treat disease, but the cost per pill can be as high as $1,000.

Although understanding both the cost-effectiveness of these new treatments and impact on the quality of life is “imperative for health policy and cost containment,”  however, it is “difficult […] to justify an intervention simply by a price tag,” Nancy S. Reau, MD, and Donald M. Jensen, MD, both of the Center for Liver Disease at the University of Chicago wrote in an editorial published in Hepatology.

Once a patient with hepatitis C virus has achieved a sustained virological response (SVR) there is a less than 1% chance for late relapse to occur, and achieving SVR is also associated with lower rates for liver cancer, cirrhosis, transplant and all-cause mortality.

“Some treatments may be equally effective but toxicity and complexity may make one a much better value,” Reau and Jensen noted. “It is difficult to argue this is not success — both for the patient as well as society. How much is this worth? What is the price of prevention?”

Data from a recent study indicate the overall annual health care cost for patients with chronic HCV is estimated to be $24,176. When assessed by disease stage, a significant proportion of the total costs were consumed by patients with advanced HCV.

“Although HCV treatment induces a fair amount of sticker shock, other approved medications [for other chronic conditions] are equally costly,” they wrote — HIV therapies can range on average from $2,000 to $5,000 per month.

Although it may be easy to understand the financial burden of HCV on the healthcare system, the potential healthcare burden is even higher if patients fail to be linked with a provider willing to administer HCV therapy, or if HCV therapy is out of reach due to barriers such as cost, Reau and Jensen concluded.