Understanding Cost and Value in Hepatitis C Therapy.

Access to newer therapies for the treatment of hepatitis C virus (HCV) infection is limited by the costs of these treatments. Newer HCV regimens have been shown to be cost-effective in early stages and late stages of the disease, but payers in the United States may refuse to reimburse for treatment of early disease because of budget constraints. Approaches that can maximize patients' access to appropriate therapy include having dedicated staff to handle prior authorizations and appeals, keeping records of successful approaches to prior authorizations and appeals and sharing these approaches with colleagues, and communicating with patients so that they will not be lost to appropriate health care. This article summarizes a presentation by Benjamin P. Linas, MD, MPH, at the IAS-USA continuing education program, Management of Hepatitis C Virus in the New Era: Small Molecules Bring Big Changes, held in Atlanta, Georgia, in September 2015.