How the Hepatitis C “Cure” is Costing American Health Care

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Hepatitis C is a viral infection that spreads through contact with the blood of an infected person and causes inflammation of the liver. Once infected, patients may not show symptoms for several years until the virus damages the liver. However, if untreated, chronic Hepatitis C infections can cause liver damage or complications that result in death. Treatment options are available, with varying degrees of success and cost.

Who Is Affected

Health informatics specialists track the number of Hepatitis C infections every year. Statistics show about 130 to 150 million people are infected globally. Of these numbers, about 350,000 to 500,000 people will die due to complications from the infection. The number of new cases in the Unites States is stabilizing, yet more than three million Americans have chronic Hepatitis C infections.

Existing Treatment Options

Until recently, the most common way that doctors treated Hepatitis C was with anti-viral medications and interferons. Interferons are proteins that the body releases to “interfere” with a virus’s ability to reproduce. These two combined types of medications are successful in curing Hepatitis C about half of the time, and the recommended course of treatment is 48 weeks. However, these treatment options have undesirable side effects that discourage many people from carrying on with treatment.

New Treatment Options

In 2013, the Food and Drug Administration approved drug maker Gilead Sciences Inc.’s Hepatitis C drug Sovaldi. This drug combined, with anti-viral treatment, cures certain types of Hepatitis C 90% of the time. The side effects for Sovaldi are fewer than traditional treatments, and depending on the type of Hepatitis C, the treatment course can only take 12 weeks. The downside to this treatment is the price tag: the cost of a 12-week regimen of Sovaldi along with two companion medications that patients must also take is about $100,000 per patient. Insurance companies are reluctant to cover the cost and often require a lengthy approval process before covering treatment.

Dealing With High Treatment Costs

The high price of Sovaldi makes this treatment option unavailable to most people. The drug maker claims that extensive research and development plus the high cost of bringing a drug to market justify the price. Gilead claims that avoiding expensive Hepatitis C complications will save money in the long run. However, the pricing of their drug prevents many from being cured. To further complicate the matter, new provisions in the Affordable Care Act in the U.S. will require state-funded healthcare programs to cover the cost of the drug. That leaves many state governments wondering how they will meet their budgets.

Possible Solutions

Since Sovaldi is still fairly new, healthcare informatics specialists are still processing data about how many patients could qualify for the drug and future need. Policymakers can use this information to start a dialogue with Gilead to discuss a price reduction for the patients who could benefit most from Sovaldi. Other drug companies may develop similar products to compete with Sovaldi and lower the cost. The combined effort of gaining more information about how this drug can help more people and competitive pressure from other drug companies may help make this drug an option for more people.