Is HCV treatment cost-effective?
Oct 09, 2019 · Treatment for hepatitis C is now done with all-oral medications. These pills, called antiviral medications, are usually taken once per day. The provider treating your hepatitis C may recommend one or a combination of two to three medications to be taken for about 12 weeks.
How is hepatitis C virus (HCV) infection treated?
However, while Sovaldi’s wholesale acquisition cost (WAC) is listed for $84,000 and Harvoni’s at $94,500 for a 12-week treatment, the average revenue per treatment reported by Gilead in 2015, including both 12- and 24-week-long treatments, was estimated to be around $54,000 and during the first 6 months of 2016 the price per treatment dropped another 22% — a possible response …
How does Medicaid pay for HCV treatment?
Jun 11, 2021 · Analysis of prescription drugs for the treatment of hepatitis C in the United States. Sovaldi, a direct-acting antiviral (DAA) treatment for hepatitis C virus (HCV), had an average wholesale acquisition cost (WAC) of $1,000 per day in …
How has the Pharmacoeconomics of HCV treatment changed?
Hepatitis C is a liver infection caused by the hepatitis C virus (HCV). Hepatitis C is spread through contact with blood from an infected person. Today, most people become infected with the hepatitis C virus by sharing needles or other equipment used to prepare and inject drugs. For some people, hepatitis C is a short-term illness, but for more ...
What is the cost of HCV treatment?
The cost of hep C treatment varies depending on the type of drug. However, an 8- to 12-week course can range from $54,000 to $95,000 (or higher). For example, the price of a 12-week course of Zepatier can be as much as $54,600, and a 12-week course of Harvoni can cost as much as $94,500.Sep 2, 2021
How much do direct-acting antivirals cost?
Conclusions: Within the next 15 years, large-scale manufacture of 2 or 3 drug combinations of HCV DAAs is feasible, with minimum target prices of $100-$250 per 12-week treatment course. These low prices could make widespread access to HCV treatment in low- and middle-income countries a realistic goal.
What are the four drugs used to treat HCV?
Here are the medications available to treat hepatitis C, plus some helpful information about what to expect with their treatment.Ribavirin. ... Direct-acting antivirals (DAAs) ... Combination drugs. ... Ledipasvir-sofosbuvir (Harvoni) ... Elbasvir-grazoprevir (Zepatier) ... Sofosbuvir-velpatasvir (Epclusa)More items...
What is the most commonly recommended treatment protocol for HCV?
Hepatitis C is treated using direct-acting antiviral (DAA) tablets. DAA tablets are the safest and most effective medicines for treating hepatitis C. They're highly effective at clearing the infection in more than 90% of people. The tablets are taken for 8 to 12 weeks.
How much is hep C treatment in India?
The generic version of these drugs are available in cities such as Bengaluru Hyderabad and Chennai at the cost of Rs70000 or around $1000 USD for the entire treatment regimen.
What is DAA treatment?
Importance Direct-acting antiviral (DAA) drugs are highly effective in curing hepatitis C virus (HCV) infection. Previous simulations showed extended life as a key health advantage of DAA drugs, but real-world evidence on the association between DAA treatment and reduced mortality is limited.Jul 21, 2020
What is the latest treatment for hep C?
The new hepatitis C treatments are sofosbuvir with ledipasvir (Harvoni); sofosbuvir (Sovaldi); daclatasvir (Daklinza); and ribavirin (Ibavyr). These new treatments are now available on the Pharmaceuticals Benefits Scheme.Mar 1, 2016
How much is sofosbuvir cost?
About Sofosbuvir / Velpatasvir The lowest GoodRx price for the most common version of sofosbuvir / velpatasvir is around $3,639.60, 64% off the average retail price of $10,220.54.
Is hep C 100 curable?
Hepatitis C is a curable liver infection that results from the hepatitis C virus. Without proper treatment, chronic hepatitis C infections can lead to severe complications, such as liver disease, liver scarring, and liver cancer.Sep 13, 2019
What is the normal range of HCV viral load?
Understanding the viral load range The viral load results from the quantitative PCR test can range from 15 to 100,000,000 IU/L. If your results are: Fewer than 15 IU/mL: The virus is detected, but the amount can't be measured exactly.
Who qualifies for hep C treatment?
With the exception of pregnant women, the World Health Organization recommends treatment be offered to all individuals aged 12 years or older diagnosed with HCV, regardless of their disease stage.Oct 7, 2019
What is the normal range of HCV?
Normal range for this assay is "Not Detected". The quantitative range of this assay is 10 - 100,000,000 IU/mL (1.0 - 8.0 log IU/mL).
How high is the cure rate for hepatitis C?
Driven by several novel regimens recently receiving approval in the US and in Europe, high cure rates exceeding 90% are now achievable for most patients suffering from chronic hepatitis C. As a result of this unprecedented success, the industry is reaching a new phase in the fight against this deadly infectious disease. The pressure is now shifting to the healthcare providers to determine if the future of hepatitis C treatment will include a (near) eradication in the developed world, or if hepatitis C will remain a debilitating and life-threatening factor in our society.
What is the treatment for hepatitis C?
The treatment of chronic infections caused by the hepatitis C virus (HCV) has undergone a dynamic shift in recent years. Historically, treatments were based on interferon, which was subsequently replaced by peginterferon, administered in combination with ribavirin.
How long does Harvoni work?
Harvoni already demonstrated high efficacy after 8 weeks of treatment in patients with GT1 and no cirrhosis, and both Gilead and Janssen are currently developing possible pan-genotypic DAAs that might be able to cure the same patient population after only 6 weeks of treatment.
What was the first NS5B inhibitor?
However, the main breakthrough came in 2013 with the approval of the first NS5B inhibitor, Gilead’s Sovaldi (sofosbuvir). Gilead followed up on the success it achieved with Sovaldi with the launch of Harvoni (a fixed-dose combination of sofosbuvir and ledipasvir, an NS5A inhibitor). The ability to cure over 95% of many patient populations, ...
How many markets does Gilead have?
Together, Sovaldi and Harvoni helped to position Gilead as the unquestionable market leader in the 9 major markets (9MM: US, France, Germany, Italy, Spain, UK, Japan, China, and Brazil), providing the pharmaceutical giant with global revenues of $19.1 billion in 2015 alone. However, other companies did not remain on the sidelines.
How long does it take to cure hepatitis C?
The ability to cure over 95% of many patient populations, simultaneously shortening treatment durations to 12 weeks with a once-daily single pill, while also eliminating peginterferon and ribavirin for most patients, truly revolutionized the hepatitis C treatment paradigm.
How many people have been treated with Sovaldi?
However, several factors are driving the market toward more inclusive national treatment approaches. In the past 3 years alone, over 1 million people have been treated with Sovaldi-based regimens. Since most of these people will have been cleared of the virus, the total prevalence in most of the 9MM is now slowly decreasing.
What does CEA mean when making coverage decisions for therapy?
When making coverage decisions for therapy, however, an insurer considers only its own revenues and expenses. Time horizon. From a societal perspective, CEA uses a lifetime time horizon, meaning it considers lifetime costs and benefits, including those that occur in the distant future.
What is cost effectiveness analysis?
Cost-effectiveness analysis (CEA) compares the relative costs and outcomes of 2 or more interventions. CEA explicitly recognizes budget limitations for healthcare spending and seeks to maximize public health benefits within those budgetary constraints. The core question that CEA addresses is whether to invest limited healthcare dollars in a new treatment/therapy or use that money to invest in another healthcare intervention that would provide better outcomes for the same monetary investment. The focus of CEA is, therefore, not simply cost or saving money but health benefits. It assumes that all available resources will be spent and provides a framework for prioritizing among available treatment options by formally assessing the comparative costs and health benefits accrued from a new treatment relative to current treatment.
What does private insurance do?
Private insurance companies often have separate pharmacy and medical budgets, and use PBMs or directly negotiate drug pricing with pharmaceutical companies. Insurance companies determine formulary placement, which impacts the choice of regimens and out-of-pocket expenses for patients.
Why is prevention of long term complications important?
Prevention of long-term complications is especially important when considering the cost-effectiveness of HCV treatments because the costs of the therapy are immediate, while those avoided by preventing advanced liver disease and other complications of chronic infection often accrue years in the future.
What is patient assistance?
Patient assistance programs offered by pharmaceutical companies or foundations can cover many of these out-of-pocket expenses or provide drugs at no cost to qualified patients who are unable to pay.
Does Medicare cover HCV?
Medicare covers HCV drugs through part D benefits and is prohibited by law from directly negotiating drug prices.
Is DAA more efficient than HCV?
In general, when given a choice between recommended HCV DAA regimens, the less costly regimen is preferred as a more efficient use of resources (even if it requires multiple tablet dosing). Because of the similar efficacy of most DAA regimens, cost becomes the critical factor driving relative cost-effectiveness.
How long does it take to get tested for hepatitis C?
Getting tested for hepatitis C is important, because treatments can cure most people with hepatitis C in 8 to 12 weeks.
How is hepatitis C spread?
Hepatitis C is spread through contact with blood from an infected person. Today, most people become infected with the hepatitis C virus by sharing needles or other equipment used to prepare and inject drugs.
Is hepatitis C a long term illness?
For some people, hepatitis C is a short-term illness, but for more than half of people who become infected with the hepatitis C virus, it becomes a long-term, chronic infection. Chronic hepatitis C can result in serious, even life-threatening health problems like cirrhosis and liver cancer. People with chronic hepatitis C can often have no symptoms ...
Is hepatitis C a risk factor?
CDC continues to recommend people with risk factors, including people who inject drugs, be tested regularly. CDC recommendations for hepatitis C screening among adults – United States, 2020. Hepatitis C is a liver infection caused by the hepatitis C virus (HCV). Hepatitis C is spread through contact with blood from an infected person.
How much money will Medicare save on HCV?
This coverage policy could save $1.4 billion over 25 years.
What is the cure rate for hepatitis C?
Direct-acting antivirals (DAAs) are associated with cure rates above 95% for hepatitis C virus (HCV). 1 However, the exorbitant costs of DAAs historically have made access prohibitive for many patients.
What is the semi infectious disease model?
The semi-infectious disease model assessed the cost-effectiveness of HCV outcomes based on increased treatment probabilities under the total coverage scenario, compared with 2 scenarios reflecting the current payer model with standard coverage for all beneficiaries or prioritized coverage for all high-risk beneficiaries ( Figure 1 ). In the latter alternative, the 60% of patients with chronic HCV who had a liver fibrosis score of 2 or higher, as opposed to a fibrosis score of 0 or 1, received DAAs first, before lower-risk patients, in order to better manage budget impact. 15
Why is Medicare not treating HCV?
Objectives: Most Medicaid beneficiaries with hepatitis C virus (HCV) are not treated with direct-acting agents because of budget constraints, but they experience costly complications after becoming Medicare eligible. Maryland’s “total coverage” proposal could receive a credit from Medicare to offset Medicaid investments in treatments ...
Is Maryland a total coverage state?
Maryland may be one of the first states to pilot the concept of a total coverage solution for HCV treatment through joint Medicare-Medicaid payments. However, most of the 50 states are grappling with similar solutions.
Is DAA coverage for HCV?
Providing total coverage for DAA medications for all patients with HCV is systematically complex and may not be economically viable for state Medicaid programs that face some of the highest rates of HCV among payers. Joint Medicaid-Medicare coverage provides an efficient solution to treat all patients now to reduce harm caused by chronic infection in the United States. Recent price reductions for HCV treatments improve the outlook on affordability at the system level, as the $26,400-plus price tag still makes it inaccessible to individual Medicaid enrollees. Furthermore, the long-term costs of untreated HCV typically borne by Medicare are offset under this concept. The Maryland TCOC model gives Medicare the option of crediting Medicaid for spending money today that it will save on health care costs in the future. This is an approach to resolve the mismatch between investing today and getting future returns.
What is the primary analysis for this methodology study focused on?
The primary analysis for this methodology study focused on the changing costs and effectiveness estimates at each time point to estimate incremental cost-effectiveness ratios. A scenario analysis was conducted using only the WAC for each drug referenced in RED BOOK to describe the effect of using list versus net price in the CEA. 21
Is hepatitis C treatment pharmacoeconomic?
With lower drug prices and increased effectiveness, the pharmacoeconomics of hepatitis C virus (HCV) treatment have rapidly changed in a very short time span, with several new products and multiple products withdrawn. Cost-effectiveness analyses (CEAs) for any treatment, including HCV, are typically fixed to answer a single question ...
Is HCV treatment effective?
Treatment effectiveness for HCV has increased steadily, while treatment costs increased substantially from 2010-2014 before decreasing to its lowest point in 2018. The dynamic nature of CEAs in a disease state with rapid pharmaceutical innovation may cause some concern for decision makers who rely on a single analysis over time. Model transparency along with resources to update or revise model assumptions would enable organizations to provide more up-to-date results to inform formulary decisions.
Drug Cost and Reimbursement
- Many organizations are involved with hepatitis C drug distribution and each can impact costs as well as decisions about which regimens are reimbursed (US GAO, 2015); (US CBO, 2015). The roles these organizations have in determining the actual price paid for drugs and who has access to treatment include the following: 1. Pharmaceutical companies determine the wholesale acqui…
Cost-Effectiveness
- Cost-effectiveness analysis (CEA) compares the relative costs and outcomes of 2 or more interventions. CEA explicitly recognizes budget limitations for healthcare spending and seeks to maximize public health benefits within those budgetary constraints. The core question that CEA addresses is whether to invest limited healthcare dollars in a new treatment/therapy or use that …
Affordability
- An intervention that is cost-effective is not necessarily affordable. Affordability refers to whether a payer has sufficient resources in its annual budget to pay for a new therapy for all who might need or want it within that year. Several characteristics of CEA limit its ability to speak to the budgetary impact of interventions being implemented in the real world. 1. Perspective on cost CEA seeks t…
Cost vs Affordability For HCV Treatment
- Despite a growing body of evidence that HCV treatment is cost-effective and may even be cost saving over the long term in some cases, many US payers—especially those offering Medicaid insurance products—continue to limit access to HCV treatment. Access has improved as cost has decreased but limitations remain. Proposed reductions in healthcare spending for Medicaid wou…
Cost-Effectiveness of Screening For HCV
- Several cost-effectiveness studies demonstrate that routine, one-time testing for HCV among all adults in the US would likely identify a substantial number of cases of HCV that are currently being missed, and that doing so would be cost-effective. One study employed simulation modeling to compare several versions of routine guidance, including routine testing for adults over the ages …
Conclusions
- Many studies have demonstrated the economic value of HCV screening (Chaillon, 2019); (Eckman, 2019); (Tasillo, 2019); (Assoumou, 2018); (Barocas, 2018); (Schackman, 2018); (Schechter-Perkins, 2018); (Lyons, 2016); (Hsieh, 2016); (Schackman, 2015) and treatment (Goel, 2018); (Chhatwal, 2017); (He, 2017); (Chahal, 2016); (Chhatwal, 2015); (Chidi, 2016); (Martin, 201…