New cures for hepatitis C — but are they affordable?

Gregory Curfman, MD
Gregory Curfman, MD, Editor in Chief, Harvard Health Publications

The public health burden of hepatitis C is enormous. This serious viral infection of the liver causes cirrhosis, liver cancer, and end-stage liver failure, often requiring liver transplantation. Over 3 million people in the United States, and 150 million worldwide, are infected with hepatitis C virus, resulting in 700,000 deaths per year.

People who are infected with hepatitis C virus often have no symptoms. The virus persists in the liver, slowly damaging liver tissue over a long period of time. For this reason, it is critical that progression of liver damage be stopped before advanced liver disease or liver cancer occurs.

But there’s some very good news: in the last few years, we have witnessed extraordinary progress in developing new drug treatments for hepatitis C.  Sofosbuvir (Sovaldi) and sofosbuvir combined with ledipasvir (Harvoni) are two well-known examples of these new drug therapies. Another new combination drug, sofosbuvir and velpatasvir, which was recently described in a report in The New England Journal of Medicine, is extremely effective against most forms of hepatitis C virus and will become the standard therapy when this combination is approved by the FDA.

But even though the new drugs can cure hepatitis C in many cases, they are not accessible to all people who need them. The new hepatitis C drugs cost between $80,000 and $150,000 per year. People with excellent insurance coverage may see low out-of-pocket costs for these drugs. But because of the expense, many insurance companies have implemented cost-shifting schemes that require high co-payments from people with less robust plans, which puts these drugs beyond reach for many people.

In the United States, hepatitis C drugs are but one example of “specialty drugs.” These are newer drugs for many chronic conditions — such as cancer and arthritis — that have been priced at levels that are unaffordable for many people who need them.

Until drugs for hepatitis C, and other specialty drugs, are priced at affordable levels, some people without sufficient financial means will be left out and unable to benefit from modern advances in drug therapy. As a society, we must find ways to make these drugs accessible to all who need them while also compensating the drug companies for their high research and development costs. This is a difficult balance, but in a society based on fairness and equity, it is one we must achieve. Because no one with hepatitis C should go without treatment.

Comments:

  1. hep_sa

    In Australia we are fortunate. The Federal Government announced in December that the new hepatitis C treatments will be subsidised for all, regardless of how they got it, how much the disease has progressed and whether they are in prison.

  2. Caroline

    New drugs can always bring us hope. But also hopelessness to those who can’t afford this. Actually there are so many people who catching diseases or even cancers but have no money and the only thing to do is waiting for death. So these issues indeed should be paid more attention.

  3. evelyn rossman

    I do not believe that people with hep c should ever be denied of the meds to take care of their hep c. I was just diagnosed with hep c. I was given 2 pts. Of blood in 1970. It was with die or get the blood. Well this was not my fault. I had a miscarriage and back then they never tested for hep c. I will be going to the liver doctor for first time this month. I am retired and have Medicare and AArp health insurance. But I am always reading that insurances do want to pay for the New meds. I do not think that is fair to anyone. After I was diagnosed my children freaked out and our family is not the same. My life is not the same. So when I go to liver doctor next Friday for the first time I will not be turned down for treatment. I have been living for 4 months not knowing if I will get treatment. Mine has not become active. My platelets got low that why I was sent to a hemotoligist. The stress of having hep c not knowing if you will get treated is just too overwelming.

  4. Balaji

    Thanks for the information on possibility for curing Hepatisis C.
    I am new to the FDA approval process…Usually how long it takes get the FDA approval before the medicines are available. How to get the further updates once this medicine is available.