Why We Should Be Willing to Pay for Hepatitis C Treatment.

The launch of oral direct-acting antivirals (DAAs) to treat chronic hepatitis C virus (HCV) infection represents a significant shift in the HCV treatment paradigm. With DAAs, the sustained virologic response (SVR) (ie, efficacy of treatment) has increased to more than 90%, treatment duration has decreased to as few as 8 weeks, and these regimens have no major side effects. Coupled with the updates in HCV screening guidelines, use of new DAAs could make HCV a rare disease in the next 20 years in the United States. However, the high price of DAAs is a barrier, and has drawn criticism from patients and payers. Challenged with a budget needed to treat all HCV patients, Medicaid has restricted these treatments in at least 30 US states to patients with advanced fibrosis stage. With more than a million patients needing HCV treatment in the next 3 to 5 years in the United States, the high price of DAAs could impact the budget of private payers and government. On the other hand, several recent studies have shown that these drugs provide a good value for the money. Furthermore, the price of DAAs has decreased since their first availability. For example, the average discounts on sofosbuvir-based regimens in 2015 have been 46%. As additional antiviral drugs become available in the near future, drug prices may decrease even further. Here, we discuss the value of HCV treatment with oral DAAs considering new discounts, the importance of treating all HCV patients, and how HCV treatment costs and value compare with that of human immunodeficiency (HIV) treatment. Value of Hepatitis C Virus Treatment