Predicting Hepatitis C Drug Discontinuation Could Cut Costs in Half

A new model that predicts when hepatitis C virus (HCV) treatment can be discontinued could cut costs by up to 50%, a recent study indicates.

Direct-acting antiviral (DAA) medications have been used to effectively treat HCV, however, the high cost of DAAs limit patient access to treatment.

“Treatment currently is standardized to be given for a set period of time, not tailored to the patient, added Scott Cotler, MD, FCO, hepatology division director for Loyola and Stritch professor. “In many cases, this may result in the prolonged use of expensive drugs with essentially no additional positive effect.”

During the study published in the Journal of Hepatology, researchers examined test results in 3 French referral centers with 58 chronic HCV patients who were treated with sofosbuvir in combination with daclatasvir, simeprevir or ledipasvir.

Blood tests were conducted at baseline, day 2, every other week, at the completion of treatment, and 12 weeks after treatment ended, to measure HCV levels. Next, mathematical modeling was used to predict the duration of treatment needed for a cure.

Using this method, researchers were able to identify when a cure was reached and predict when therapy should be discontinued. This model could allow for effective personalized treatment that also reduces drug cost and duration.

“The use of early viral-kinetic analysis has the potential to individualize duration of DAA therapy with a projected cost savings of 16% to 20% per 100 treated persons and up to 50% in about 40% of patients,” Dahari wrote. “Shorter regimens with low pill burdens, and few adverse effects, could improve patient adherence in difficult to treat populations.”