Treatment FAQ

what is total wac for hcv treatment drug

by Israel Senger Published 3 years ago Updated 2 years ago

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(DAA) treatment for hepatitis C virus (HCV), had an average wholesale acquisition cost (WAC) of $1,000 per day in 2013, or $84,000 for a 12-week course of treatment.

Full Answer

Is HCV treatment cost-effective?

Jun 11, 2021 · Download PDF 0.5MB. Share. 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 2013, or $84,000 for a 12-week course of treatment. Sovaldi’s launch kicked off the second generation of DAAs for HCV, which expanded more widely tolerable treatment options to …

How does Medicaid pay for HCV treatment?

When using WAC as the primary drug price input, the 2018 HCV treatment option was still preferred to other scenarios . Depending on the decision maker’s willingness-to-pay threshold ($50,000/QALY, $100,000/QALY, and $150,000/QALY), the final determination of cost-effectiveness may have changed.

How has the Pharmacoeconomics of HCV treatment changed?

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 is hepatitis C virus (HCV) infection treated?

Jun 16, 2016 · A number of analyses on novel HCV treatments have been published, demonstrating that expensive drugs can still be cost-effective.[1, 16, 40–43] In a recent analysis based on US costs, the incremental cost effectiveness ratios of DAAs compared to a reference treatment strategy, based on BOC, RBV and pegIFN-α, varied between 14,432 and 70,097 ...

What is the cost of HCV treatment?

A 2018 study found that a single pill of one hepatitis C drug cost $1,000. The total was $84,000 for its 12-week course of treatment. Another drug cost $23,600 per month. That's for treatment that could take 6 months to a year.Jun 26, 2020

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...

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 is the cost of the drug Harvoni?

Ledipasvir-sofosbuvir (Harvoni): The average wholesale cost for Harvoni is $1,125 per pill. An 8-week treatment course is $63,000 while a 12-week treatment course is $94,500 and a 24-week one is $189,000.Nov 21, 2018

What is the best hep C drug?

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.

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 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

How do direct-acting antivirals work?

Direct-acting antivirals work by blocking the action of proteins which are essential for making new hepatitis C viruses.

Does insurance cover hep C drugs?

Not all health insurance plans cover all prescribed medications for HCV treatment with few exceptions. Most insurers cover Sovaldi. It has an estimated copay of $75 to $175 per month. Check with your insurance provider to see what your individual coverage may entail.

How can I get hep C treatment for free?

Patient assistance programs (PAPs) offer free hepatitis C drugs to lower-income people who are uninsured or underinsured, and who do not qualify for insurance programs such as Medicaid or Medicare.

How much is a 12 week supply of Harvoni?

Harvoni costs $94,500 for a 12-week treatment.Feb 5, 2019

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.

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.

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.

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.

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
See more on hcvguidelines.org

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 …
See more on hcvguidelines.org

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…
See more on hcvguidelines.org

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…
See more on hcvguidelines.org

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 …
See more on hcvguidelines.org

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…
See more on hcvguidelines.org

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