Editorial: patients' preferences and health utility assessment in those with HCV treated with sofosbuvir - stating the obvious? Authors' reply

Abstract

We appreciate the editorial by Lim et al. about our recent study.1,2 Indeed, investigating into the factors that influence patients' decision to start treatment is an important clinical problem. In fact, we have tried to investigate this issue in a recent study using National Health and Nutrition and Examination Survey (a sample of the U.S. general population), 3 where participants with HCV who chose not to undergo treatment were asked about their reasons. Although these surveys were done during interferon era, only 6% of patients reported their reason to be the fear of side effects. On the other hand, the most common reason for patients not receiving treatment (62%) was a recommendation from their providers, most likely driven by contraindications to interferon-based regimens. With sofosbuvir-based treatment regimens resulting in very high cure rates, short duration and relatively better side effect profile, especially with interferon-free regimens, this will be less of an issue. Also, it is important to point out that our study was designed to assess health utilities and patient-reported outcomes during treatment with sofosbuvir regimens in a clinical trial setting. The study subjects were already referred to the clinical trials and their answers about treatment preferences would have been clearly biased. Therefore, although interesting, this research question was not a part of our study design. Nevertheless, this issue should be addressed in the future, after approval of these regimens, using data collected in clinical practice setting. ACKNOWLEDGEMENTThe authors' declarations of personal and financial interests are unchanged from those in the original article.