The cost-effectiveness of novel direct acting antiviral agent therapies for the treatment of chronic hepatitis C.

In the USA, over 3 million individuals are infected with the HCV and 75-85% of them have or will develop chronic hepatitis C (CHC) which can lead to serious consequences such as liver cirrhosis, cancer and death. The old standard of care for the treatment of CHC was Pegylated-Interferon + Ribavirin with or without a protease inhibitor such as Boceprevir/Telaprevir. These treatments had a cure rate or rate of sustained virologic response of 66-80%. Since the close of 2013, several new direct acting antiviral agents (DAAs) for the treatment of CHC have been approved by the US FDA and have entered the US drug market. These novel CHC treatments boast very high cure rates of 80-100% and come with matching high price tags. Costs of CHC regimens that contain these novel DAAs range from $63,000 to $168,000 per treatment course. Using electronic databases, studies evaluating the cost-effectiveness of novel CHC treatments in USA were reviewed, and the reported incremental cost-effectiveness ratios based on cost per additional quality adjusted life year gained from the studies reviewed indicated that some novel DAA regimens are cost-effective; however, cost-effectiveness is contingent upon a variety of factors such as HCV genotype (1-4), presence of liver cirrhosis, patient treatment history and willingness-to-pay thresholds.