Cost effectiveness of hepatitis C direct acting agents

ABSTRACT

Introduction

Introduction of direct acting antivirals (DAA) has transformed treatment of chronic hepatitis C (HCV) and made the elimination of HCV an achievable goal set forward by World Health Organization by 2030. Multiple barriers need to be overcome for successful eradication of HCV. Availability of pan-genotypic HCV regimens has decreased the need for genotype testing but maintained high efficacy associated with DAAs.

Areas covered

In this review, we will assess the cost-effectiveness of DAA treatment in patients with chronic HCV disease, with emphasis on general, cirrhosis, and vulnerable populations.

Expert opinion

Multiple barriers exist limiting eradication of HCV, including cost to treatment, access, simplified testing, and implementing policy to foster treatment for all groups of HCV patients. Clinically, DAAs have drastically changed the landscape of HCV, but focused targeting of vulnerable groups is needed. Public policy will continue to play a strong role in eliminating HCV. While we will focus on the cost-effectiveness of DAA, several other factors regarding HCV require on going attention, such as increasing public awareness and decreasing social stigma associated with HCV, offering universal screening followed by linkage to treatment and improving preventive interventions to decrease spread of HCV.

KEYWORDS:

• Hepatitis C
• antiviral therapy
• direct acting agents
• cost effectiveness
• hepatitis c elimination

Article highlights

• Treatment for hepatitis C (HCV) with direct acting antivirals (DAA) remains highly effective with the newer pan-genotypic regimens and carry minimal side effects.

• Cost effectiveness studies to date support the use of pan-genotypic DAAs for treatment of HCV and will help further our current efforts to eliminate HCV by 2030.

• Treatment costs, closely followed by treatment success, were most likely to influence cost effectiveness analysis.

• Public policy efforts will play a key role in eradication of HCV as there is a need to improve public awareness and to decrease social stigma associated with HCV.

• There is growing need for universal screening of HCV followed by linkage to treatment, especially in the vulnerable populations.

Declaration of interest

S Saab reports being on the Speaker Bureau and an Advisor to Gilead. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.