Editorial Commentary: Getting Smart in How We Pay for HCV Drugs: KAOS vs CONTROL
Clinical Infectious Diseases JUL 15, 2015 V.61 N.2 P.169-170
Center for AIDS Research, University of Alabama at Birmingham
Correspondence: Michael S. Saag, MD, Director, Center for AIDS Research, University of Alabama at Birmingham, 845 – 19th St South, Birmingham, AL 35294-2107 (email@example.com).
Over the last 2 years a therapeutic revolution has been occurring for the treatment of hepatitis C virus (HCV) infections. Direct acting antiviral (DAA) agents that allow all-oral regimens have been released.
These regimens replace the use of injectable peginterferon, which markedly reduce adverse effects, significantly reduce the duration of treatment (eg, from 48 weeks to 12 weeks), and increase cure rates from 60% to 70% to greater than 95% in most clinical scenarios .
Based on this set of facts alone, a clear message is that virtually every patient with chronic HCV should be treated . Now.
As the new HCV agents were released, however, the price-tag of the drugs created sticker shock, especially among the payers who were not fully prepared to treat so many patients at one time with such expensive medications.
To keep expenditures under control, payers questioned the need to treat patients with less advanced disease (eg, those with F0- F2 fibrosis), owing to the uncertainty of who will progress (less than 50% of patients develop cirrhosis over 30 years) and the relatively slow progression of disease among those who do progress.
The payer’s reluctance to pay for drugs created barriers for patients and providers to gain access to therapy. All involved called out for data on the cost-effectiveness of the new all oral regimens, which heretofore did not exist.
In this issue of CID, Rein and colleagues provide, for the first time, the cost-effectiveness data for …
The Cost-effectiveness, Health Benefits, and Financial Costs of New Antiviral Treatments for Hepatitis C Virus The Effect of Universal Glove and Gown Use on Adverse Events in Intensive Care Unit Patients