New hep C drugs will strain the system: MD Anderson study

The cost of treating people infected with the hepatitis C virus (HCV) with newly approved therapies is likely to place a tremendous economic burden on the country’s healthcare system, according to a study published in the March 17 issue of the Annals of Internal Medicine.

The prediction comes from a cost-effectiveness analysis led by researchers at The University of Texas MD Anderson Cancer Center. The findings predict that the cost of providing patients their daily regimens could total $136 billion over 5 years - 10% of the country’s annual spending on prescription drugs.

Chhatwal

Jagpreet Chhatwal, PhD, study leader and assistant professor of Health Services Research at MD Anderson, reported that as opposed to the old standard of care, a combination of sofosbuvir and ledipasvir (Harvoni), recently approved by FDA to treat hepatitis C, was shown to be cost-effective. The budget needed to treat all diagnosed patients, however, is unsustainable, according to the study.

Related:Hepatitis C therapies, compounded meds drive increase in U.S. drug spending

Chhatwal and colleagues developed a comprehensive microsimulation model to project the long-term outcomes of treatment with sofosbuvir and ledipasvir. They evaluated treatment in patients with 4 major HCV genotypes; patients who were treatment naïve and patients previously treated, and patients who were tolerant to interferon and those who were intolerant.

The researchers found that the new therapies would reduce the clinical burden of the disease. They determined that the newer, more expensive medications would be most beneficial for select groups of patients: those with advanced disease, those who have the HCV genotype 1, and those who are younger.

The study was finalized prior to FDA approval of ombitasvir, paritaprevir, and ritonavir tablets co-packaged with dasabuvir tablets (Viekira Pak, AbbVie), and before Gilead’s announcement that discounts on sofosbuvir (Sovaldi) would be discounted up to 46% on average. In subsequent analysis using older discounts for 2014 and then applying the 46% discount for 2015 onward, Chhatwal predicted that the budget needed would be $90 billion over 5 years (versus $136 billion). Compared with old drugs, new therapies would cost an additional $20 billion (versus $65 billion), with $16 billion in cost offsets. 

Related:CVS Health commits to Gilead's hepatitis C drugs

“The results show that using new therapies is cost-effective in the majority of patients,” Chhatwal said. “Our analysis clearly does not support an assertion that the new treatments will save healthcare money using the drug discounts given in 2014.

“However, the recent discounts announced by Gilead could change the outlook,” he added. “The budget needed to treat all eligible patients is unsustainable for any payer.”

More than 2 million people are infected with HCV, a virus found in the liver. It is transmitted through blood-to-blood contact.

“While lower drug prices will help, that’s not sufficient,” Chhatwal said. “Both the government and private insurers will need additional resources to effectively manage this epidemic.”