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Experts: HCV elimination requires less restrictions, more price negotiation

Researchers compared estimated national costs of direct-acting antiviral therapy between Germany and Australia to clarify what steps may be necessary to achieve the WHO hepatitis C elimination goals, according to a recently published editorial.

“The ambitious targets for HCV elimination set by WHO are achievable in many countries globally, but will require researchers, healthcare providers, policy makers, the affected community and the pharmaceutical industry in other countries to work together to make this happen,” Gregory J. Dore, PhD, and Jason Grebely, PhD, from the Kirby Institute, University of New South Wales, Sydney, wrote in their editorial.

In a recent study, researchers estimated the costs of DAA therapy on Germany’s health insurance system from 2010 to 2015. In 2014, approximately 6,967 patients had received DAA therapy for an estimated cost of 664 million euros. In 2015, approximately 20,088 patients had received DAA therapy for an estimated 1.325 billion euros.

Dore and Grebely compared those results with preliminary data from the initial 7 months of subsidized universal DAA availability in Australia in 2016. The Australian government committed the equivalent of 730 million euros for an initial 5-year period.

In Australia, DAA therapy is available to all chronic HCV patients aged at least 18 years, with no restrictions on liver disease stage, drug and alcohol use, prescriber or HCV reinfection.

In comparison, the researchers report that 91% of European Union and European Economic Area countries require a specialist to prescribe DAAs, 76% had at least some restriction based on fibrosis stage and 18% required abstinence of substance use prior to treatment.

The researchers estimated that 25,890 patients with chronic HCV in Australia have initiated DAA therapy since March 2016 and pharmaceutical rebates were likely in the range of 6,000 euros to 7,200 euros per course.

“This ten-fold disparity in DAA drug pricing between two high income countries highlights inconsistencies within national HCV responses and potentially will have a major impact on the capacity to achieve World Health Organization ... HCV elimination goals,” Dore and Grebely wrote. “Broad DAA access requires negotiations to lower DAA prices (or discounts to list prices) which in turn will lead to the removal of restrictions still in place in many countries. The pharmaceutical industry has demonstrated that it is willing to come to the negotiating table for such discussions.’”– by Talitha Bennett

Reference:

Zimmerman R, et al. J Hepatol. 2017;doi:10.1016/j.jhep.2017.01.024.

Disclosures: Dore reports he is a consultant and advisor for and has received research grants from AbbVie, Bristol-Myers Squibb, Cepheid, Gilead, Merck, Janssen and Roche. Grebely reports he is a consultant and advisor for and has received research grants from AbbVie, Bristol-Myers Squibb, Cepheid, Gilead Sciences and Merck.