The Burden of Hepatitis C Now That it Can be Cured and the Cost of Curing

SAN FRANCISCO, Nov. 16, 2015 /PRNewswire/ -- Jagpreet Chhatwal, PhD, 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 noninstitutionalized 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.  

According to Dr. Chhatwal, "The most important message we got from our analysis was that even in the era of DAAs, HCV burden would remain substantially high. For instance, under current management practices, 300,000 will die from HCV in the next 3 decades. This seems very high when we essentially have a cure for a disease."

The second study evaluated the cost of HCV care. Prior to the launch of DAAs, the annual cost of HCV care was $7 billion, which in 2015 has grown to $21 billion; 78 percent of the total spending was on HCV treatment. However, the cost is predicted to decrease sharply. Dr. Chhatwal predicts the annual HCV treatment cost will drop below $2 billion by 2020 and to $14 million by 2030. The availability of generics, in 2030, would have a minimal effect on the total cost of treatment because the majority of patients would have been treated by then.

Dr. Chhatwal and his colleagues estimate that it will require $106 billion to make HCV a rare disease in the next 25 years. The budget needed to manage HCV is large but substantially lower than the current spending on HIV. For instance, the United States spent $144 billion on HIV/AIDS in the last 5 years only. They concluded that aggressive screening and treatment policies are needed to reduce the burden of HCV, resulting in improved health outcomes for patients with HCV and ultimately a decrease in health resources used. Dr. Chhatwal said "HCV burden will remain high even in the era of DAAs. We are not done yet! There is a need for more aggressive screening and treatment policies. More resources are needed to maximize the benefits of DAAs."

Dr. Chhatwal also addressed the issue of the need for developing a vaccine to eradicate HCV, "This has become an important question given that we have highly effective DAAs. We have to keep in mind that even after a successful treatment, people can still become re-infected. So a vaccine may play a role in reducing HCV incidence. On the other hand, will we need a vaccine if the cost of DAAs drops substantially? It is an interesting economics question." 

Abstract title: 

1.       Hepatitis C disease burden in the United States in 2015 and beyond

2.       The cost of making hepatitis C a rare disease in the United States

AASLD is the leading medical organization for advancing the science and practice of hepatology. Founded by physicians in 1950, AASLD's vision is to prevent and cure liver diseases. This year's Liver Meeting®, held in San Francisco, CA, November 14-17, will bring together more than 9,000 researchers from 55 countries.

A pressroom will be available from November 13 at the annual meeting. For copies of abstracts and press releases, or to arrange researcher interviews, contact Gregory Bologna at 703-299-9766.

Press releases and all abstracts are available online at www.aasld.org.

Media Contact: Gregory Bologna
703/299-9766
[email protected]
Press Room: November 13 – 17, 2015
Moscone West Convention Center, San Francisco, CA
Telephone: 415-348-4404

Researcher: Jagpreet Chhatwal, PhD
Email: [email protected]
Phone (cell): 608-334-3292 

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SOURCE American Association for the Study of Liver Diseases (AASLD)

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