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Spending on Hepatitis C Antivirals in the United States, 2009-2015

Katie J Suda1,2, Drew J Halbur3, Robert J Hunkler4

  • 1Department of Veterans Affairs, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Chicago, Illinois.

Pharmacotherapy
|November 19, 2016
PubMed

Insights

New hepatitis C virus (HCV) antiviral drug spending surged from $78 million in 2009 to $18 billion in 2015. This increase is driven by highly effective but costly new HCV therapies, impacting overall healthcare expenditures.

Area of Science:

  • Pharmacoeconomics
  • Hepatology
  • Health Services Research

Background:

  • New hepatitis C virus (HCV) antivirals offer high efficacy and minimal side effects.
  • The significant cost of these novel treatments raises questions about their impact on overall healthcare spending.
  • Limited data exists on the expenditure patterns of HCV antivirals across different healthcare sectors in the U.S.

Purpose of the Study:

  • To analyze and describe HCV antiviral expenditures in the U.S.
  • To delineate spending by specific drug agents, by year, and by healthcare sector.

Main Methods:

  • Retrospective cross-sectional study design.
  • Utilized QuintilesIMS National Sales Perspectives database from January 1, 2009, to December 31, 2015.
  • Analyzed HCV antiviral expenditures based on agent, year, and healthcare sector.

Main Results:

  • HCV antiviral expenditures dramatically increased from $78 million in 2009 to $18 billion in 2015.
  • A notable spending decrease occurred in 2013, potentially due to treatment 'warehousing' awaiting new drug approvals.
  • Expenditures shifted from interferons to newer agents like telaprevir and sofosbuvir-containing regimens over the study period.
  • Mail service and community pharmacies accounted for the majority of expenditures.

Conclusions:

  • Newer HCV antivirals are the primary drivers of increased class expenditures.
  • The trend suggests continued expenditure growth, contingent on payer actions and drug development.
  • Future medication policies must balance treatment efficacy and safety with long-term cost-effectiveness for HCV management.
Abstract

Keywords:
Hepatitis Cantiviralexpendituresprescribing practiceswithholding treatment

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