Burden of hepatitis C now that it can be cured and the cost of curing

Jagpreet Chhatwal, senior scientist at the Institute for Technology Assessment
Massachusetts General Hospital, presented two studies at the annual meeting of the American Association for the Study of Liver Diseases that addressed the burden of hepatitis C virus (HCV) and the cost of treating patients with the disease.

The second generation of direct-acting antivirals (DAAs) that are currently used to treat patients with HCV were approved in 2013 and have achieved an almost universal cure rate. As Dr Chhatwal states in one of his abstracts, the high price of these DAAs has been criticized by patients and payers. He also describes the field of HCV as very dynamic in terms of screening policy, availability of therapies, and insurance coverage expansion.

It is estimated that 2 million non-institutionalized Americans have HCV in 2015, and 45% of them are still unaware of their infection. Because of the availability of highly effective therapies, the number of HCV-infected people will drop below 1 million by 2020. However, even in the era of oral DAAs, HCV burden would remain substantial—317,000 will die, 154,000 will develop liver cancer, 198,000 will develop decompensated cirrhosis, and 31,000 will get liver transplant.