Full Access to Hepatitis C Drugs Could Save Billions Long-Term

Restricted access to antiviral HCV treatments only reduces spending in the short-term.

A recent study found that the current practice of limited access to interferon-free hepatitis C virus (HCV) treatments were costlier and less effective than full access to the treatments.

Both Medicare and Medicaid are effected by the high cost of interferon-free treatments since they treat a large population of patients with HCV, according to a study published by Value in Health. The researchers used a Markov state-transition model to calculate the cost-effectiveness of the current practice of limiting treatment compared with full access to treatment.

Included in the study were 450,000 Medicaid beneficiaries 45- to 55-years-old, who were assumed to have HCV. In the model, patients were assumed to be treated with a 2-drug combination of sofosbuvir/ledipasvir or a 3-drug combination of ombitasvir, paritaprevir, and ritonavir with dasabuvir, according to the study.

Researchers found that in the best case scenario, full access to treatment saved money and was more effective throughout all age cohorts. In the 50-year-old age cohort, the current practice ($30,610,5.47 QALYs) cost an additional $9200 per patient with 0.84 fewer QALYs compared with full access to treatment ($21,410, 6.31 QALYs).

Researchers also found that savings from full access to treatment increased with the age of patients. They also found there would be cost savings for both Medicaid and Medicare if full access to treatment was implemented.

The findings indicate that full access could save the US Centers for Medicare and Medicaid Services $10,340 per patient in the 45-year-old cohort, $8148 for 50-year-olds, and $5695 for 55-year-olds, according to the study. Even in the worst case scenario, researchers still reported a savings of between $3197 and $3568 per patient.

Researchers believe the initial costs could be outweighed by the savings from not needing treatment for serious complications later in life. Full access to treatment could potentially save more than $3.5 billion for approximately 450,000 Medicaid beneficiaries who have HCV, according to the study.

The researchers noted that the current strategy of restricted access to HCV treatment is not only more expensive than full access to treatment, it can allow the disease to progress to cancer and liver transplantation. In order to implement full access to treatments, state and federal payers should collaborate in an effort to minimize costs and maximize patient outcomes, the study concluded.