As the price of the new hepatitis C drugs continues to cause a rumpus, researchers in the USA have been trying to put a price on treating all patients in the country and comparing it to potential savings.
Researchers from MD Anderson have reported at the American Association for the Study of Liver Diseases meeting in Boston their attempt to do so. For this study, they developed a model that simulated the natural history of HCV in treatment-naïve and experienced patients and included currently diagnosed patients, as well as those who would be diagnosed by the age-based screening recommended by the Centers for Disease Control and Prevention (CDC) in the States.
They then simulated treatments using the new direct-acting antivirals – Gilead Sciences’ Sovaldi sofosbuvir and Johnson & Johnson’s Olysio (simeprevir) plus Gilead’s recently-approved combo Harvoni (sofosbuvir/ledipasvir) – based on practice guidance. They also used published sources for “specific annual and treatment costs”.
The total number of patients to be treated in their model was 1.6 million at a cost to all payers of $136–188 billion over the next five years. That is $65 billion more than the cost of drugs used prior to the new antivirals, so cost-offset because of the new therapies would be only $16 billion.
The MD Anderson team say that treating the large number of HCV patients would be “immense and likely unsustainable”. Jagpreet Chhatwal, principal investigator for the study, claimed that “the best strategy is to treat everyone. Unfortunately, we are not seeing it happening in practice because of the cost of treatment. Either we need to reduce the price of drugs or make the best use of available resources by evidence-based prioritisation”.
Dr Chhatwal concluded by saying “we need a multiple-pronged approach consisting of additional government funding, price negotiations, and need-based prioritisation to effectively treat all HCV patients in the USA”.
