title: Broad Hepatitis C Treatment Scenarios Return Substantial Health Gains, But Capacity Is A Concern.
abstract: Treatment of hepatitis C virus, the most common chronic viral infection in the United States, has historically suffered from challenges including serious side effects, low efficacy, and ongoing transmission and reinfection. Recent innovations have produced breakthrough therapies that are effective in more than 90 percent of patients. These treatments could dramatically reduce the virus's prevalence but are costly. To quantify the benefit of these treatments to society, including the value of reduced transmission, we estimated the effects of several hepatitis C treatment strategies on cost and population health. Treating patients at all disease stages could generate $610-$1,221 billion in additional quality-adjusted life-years, plus an additional $139 billion in saved medical expenditures over fifty years, and minimize the disease burden, but up-front treatment costs would exceed $150 billion. An intermediate scenario--treating 5 percent of the infected population annually, regardless of patients' disease stages--would also return substantial benefits and would be much more affordable under current financing schemes.
authors.affiliation: Karen Van Nuys is a senior research economist at Precision Health Economics, in Los Angeles, California.
authors.forename: Karen
authors.initials: K
authors.lastname: Van Nuys
authors.affiliation: Ronald Brookmeyer is a professor of biostatistics at the University of California, Los Angeles.
authors.forename: Ronald
authors.initials: R
authors.lastname: Brookmeyer
authors.affiliation: Jacquelyn W. Chou is an associate director and research scientist at Precision Health Economics.
authors.forename: Jacquelyn W
authors.initials: JW
authors.lastname: Chou
authors.affiliation: David Dreyfus is a data scientist at Arete Analytics, in Andover, Massachusetts.
authors.forename: David
authors.initials: D
authors.lastname: Dreyfus
authors.affiliation: Douglas Dieterich is a professor of medicine in the Division of Liver Diseases at the Icahn School of Medicine at Mount Sinai, in New York City.
authors.forename: Douglas
authors.initials: D
authors.lastname: Dieterich
authors.affiliation: Dana P. Goldman (dana.goldman@usc.edu) is the Leonard D. Schaeffer Chair and director of the Schaeffer Center for Health Policy and Economics at the University of Southern California, in Los Angeles.
authors.forename: Dana P
authors.initials: DP
authors.lastname: Goldman
mesh_terms: D003362:Cost-Benefit Analysis; D017048:Health Care Costs / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006526:Hepatitis C / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology; D006801:Humans; D015233:Models, Statistical; D019057:Quality-Adjusted Life Years; D014481:United States / Q000453:epidemiology
keywords: Access To Care; Epidemiology; Health Economics; Health Promotion/Disease Prevention; Health Spending