Despite the high cost of novel direct-acting antiviral (DAA) treatments for hepatitis C virus (HCV) infections, high patient cost arrangements that impose large out-of-pocket expenses are “sub-optimal solutions,” according to a new commentary.
“Many policymakers have focused on what they see as a high price for three months of therapy, but the value of curing hepatitis C lasts a lifetime,” said Darius Lakdawalla, Quintiles Professor of Pharmaceutical Development and Regulatory Innovation at the University of Southern California Schaeffer Center for Health Policy and Economics..
When DAAs were launched in 2013, their high cost raised protests from insurers and health systems. The concerned was that treating the estimated 3.5 million Americans HCV patients would bankrupt the healthcare system. As a result, some insurers shifted the cost burden partly onto patients by placing DAAs into high-cost specialty drug tiers.
“This approach might seem appealing and equitable at some level, but closer reflection reveals that it would expose patients with HCV to potentially significant financial burdens at a time when they are least able to cope with them,” writes Lakdawalla in a commentary in the American Journal of Managed Care.
He notes that higher cost sharing did not discourage adherence to earlier HCV regimens and patients appeared to be willing to bear higher out-of-pocket costs for the older generation of drugs. “Economic theory would suggest that they would be just as, if not more, willing to bear higher out-of-pocket costs for the newer, more effective and more tolerable generation of drugs,” he writes.