title: The impact of the new antiviral regimens on patient reported outcomes and health economics of patients with chronic hepatitis C.
abstract: Hepatitis C is an important cause of chronic liver disease worldwide with an estimated 170 million people infected. Hepatitis C virus (HCV)-infected patients are physically and mentally impacted by fatigue, depression and anxiety causing an impairment of health related quality of life (HRQOL), lower worker productivity and other patient reported outcomes (PROs). Although anti-HCV regimens containing first generation direct acting antiviral agents (DAAs) were associated with significant side effects, the second generation DAAs, sofosbuvir (SOF) and simeprevir (SMV), are associated with fewer side effects, better tolerability and high cure rates. Despite these advantages, key stakeholders are currently trying to find ways to best integrate these new therapeutic regimens into the management of patients with chronic hepatitis C for the benefit of all. The purpose of this article is to offer insight into the other key and equally important outcomes (PRO's, HRQOL and cost) which should be considered when assessing the applicability of these new regimens for the care of patients infected with HCV. Our review provides evidence that the new treatment regimens for HCV not only have high efficacy rates but are also associated with better patient reported outcomes and cost per case of HCV cured. Additionally, compared to other medical interventions, these new regimens are cost-effective from a societal perspective.
authors.affiliation: Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, Virginia, USA; Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, Virginia, USA. Electronic address: zobair.younossi@inova.org.
authors.forename: Zobair
authors.initials: Z
authors.lastname: Younossi
authors.affiliation: Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, Virginia, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Henry
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage* / Q000191:economics; D003362:Cost-Benefit Analysis; D004359:Drug Therapy, Combination; D016174:Hepacivirus / Q000302:isolation & purification; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000191:economics; D006575:Heterocyclic Compounds, 3-Ring / Q000008:administration & dosage / Q000191:economics; D006801:Humans; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D000069616:Simeprevir; D000069474:Sofosbuvir; D013449:Sulfonamides / Q000008:administration & dosage / Q000191:economics; D016896:Treatment Outcome; D014542:Uridine Monophosphate / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000191:economics
chemical_list: D000998:Antiviral Agents; D006575:Heterocyclic Compounds, 3-Ring; D013449:Sulfonamides; D000069616:Simeprevir; D014542:Uridine Monophosphate; D000069474:Sofosbuvir
keywords: Health-related quality of life; Simeprevir; Sofosbuvir