The cost of successful antiviral therapy in hepatitis C patients: a comparison of IFN-free versus IFN-based regimens at an individual patient level in Australia

Abstract

BackgroundChronic hepatitis C remains a major global health burden with serious long-term consequences if left untreated. Recently the treatment standard of care has shifted to new interferon (IFN)-free drug regimens, which have been shown to be safe and effective. The aim of our study was to assess and compare medical resource utilization and costs of successfully treating patients with IFN-based and IFN-free therapies in Australia.MethodsWe performed a retrospective chart review of 30 HCV-infected patients successfully treated with IFN-based therapy between 2013 and 2015. We also generated a model for a virtual group of 100 genotype 1 (GT1) and 100 genotype 3 (GT3) patients treated with IFN-free therapy derived from national guidelines and clinical trial data.ResultsIn comparison to virtual patients receiving IFN-free therapy, our IFN-treated patients on average had distinctively more liver clinic visits and blood tests. However, mean total cost per patient was $19,164 and $85,300 (AUD) more for GT1 and GT3 patients receiving IFN-free therapy, respectively. This difference was largely accounted for by higher antiviral drug costs. Of our 30 patients treated with IFN, total mean cost per patient during the study period was $33,595.ConclusionResource utilization is lower with IFN-free treatment, which reflects the reduced need for patient monitoring and improved side-effect profile of these new drugs. However, total costs are still largely dominated by antiviral drug costs, representing a huge burden on national budgets. Our insight into resource utilization and costs associated with both types of treatment can serve as a reference for future studies.

Budget impact analysis of two treatment approaches for hepatitis C in Malaysia through the use of voluntary and compulsory licensing options

“…When the cost of the sofosbuvir/velpatasvir drug is reduced by 10, 20, and 50% from the current price of USD480 per treatment, the cumulative savings over the 5 years between scenarios A and B were estimated to be USD 1.6, 2, and 3 million, respectively. This study found that DAA drug was the key cost driver across all disease stages, ranging from 46 to 80% of the cost, which is consistent with findings from previous studies (4,21,23). Similarly, in the era of interferon-based treatment, HCV drug cost was also found to be the main driver of high treatment cost (4,22).…”

“…This study found that DAA drug was the key cost driver across all disease stages, ranging from 46 to 80% of the cost, which is consistent with findings from previous studies (4,21,23). Similarly, in the era of interferon-based treatment, HCV drug cost was also found to be the main driver of high treatment cost (4,22). The higher cost of HCV treatment with interferon-based drugs was related to the need for multiple courses of therapy and extended treatment duration (4) due to the low efficacy and higher failure rates of interferon.…”

“…Chronic hepatitis C viral (HCV) infection and its complications carries huge costs to individual patients, affected households and healthcare providers (1,2). The cost of HCV drugs constitutes the largest proportion ranging from 85 to 90% of the total direct medical costs and the cost has escalated further with the use of new antiviral drugs (3,4).…”