Best HCV Value? Screen All Baby Boomers, Treat All Infections
Key clinical point: Screening adults born in 1945-1965 and treating all who have HCV with oral anti-HCV regimens is most cost effective.
Major finding: The strategy’s incremental cost of $36,585 is below the $50,000 per QALY threshold for cost effectiveness.
Data source: A computer simulation analysis that compared four strategies for screening and treatment, with treatment costs based on an estimated $1,000/day for sofosbuvir.
Disclosures: Dr. Younossi reported having no financial disclosures. One of his coinvestigators reported financial associations with Gilead, which markets sofosbuvir, and Bristol-Myers Squibb.
AT THE LIVER MEETING 2014
As advocates for patients, physicians need to lobby officials so that “as they are dividing the pie, hepatology and HCV are represented,” he said. “These regimens are cost effective.”
The study was an underestimation of savings from birth cohort screening and treating all HCV positives, Dr. Younossi noted, because it did not incorporate an estimated $3 billion per year in savings from work productivity in the United States by curing HCV.
A physician in the audience countered Dr. Younossi’s call for more enlightened health policy supporting funding for HCV treatment, noting that drug companies also need to be pressured to lower the price of the newer drugs.
“The biggest bridge we have to cross is the cost of the drugs,” he said. “This is like denying somebody treatment for tuberculosis by making the cost of the drug too high.”
“I agree,” Dr. Younossi said. “We have to focus on our colleagues in the industry. But we also have to focus on our colleagues in Congress and the policymakers to make sure that, even if we get help from the industry side, we also get help from the policymakers to provide us” with the funding for access to HCV screening and treatment.
Dr. Younossi reported having no financial disclosures. One of his coinvestigators reported financial associations with Gilead and Bristol-Myers Squibb.
