FOCUS OF THE WEEK
Certain Patients May Wait for Newer Hepatitis C Drugs
March 12, 2014, 11:53:17 AM
Katie Sullivan, MA
While newer drugs used to treat hepatitis C virus may be more effective, they may not always be the best value option for patients. This is because the costs of emerging treatments can range from $60,000 to $80,000 per treatment course, and that cost undermines the ultimate goals of lowering healthcare costs in the US.

“I can’t imagine how that would be feasible without bankrupting our system,” said Rena K. Fox, a professor of medicine at the University of California, San Francisco. “What I really wish for is that we could push back on the price, rather than make patients wait. But since we don’t have the ability to change the price, we have to decide which patients are the most urgent.”

Pharmaceutical companies often argue that research and development add to the costs of innovative medications. In fact, a recent Forbes study suggested that the average cost of producing a new drug can be as much as $5 billion.

“This is crazy. For sure, it’s not sustainable,” said Susan Desmond-Hellmann, the chancellor at University of California, San Francisco. “Increasingly, while no one knows quite what to do instead, any businessperson would look at this and say, ‘You can’t make a business off this. This is not a good investment.’ I say that knowing that this has been the engine of wonderful things.”

As well, patients aren’t always open to the concept of receiving “old” medications over newer offerings.

“If I was hepatitis C-positive, and someone said there’s this great treatment, but can you hold off because you’re healthy and it might bankrupt the system… patients don’t think like that,” said Ryan Clary, executive director of the National Viral Hepatitis Roundtable.

Advocates and experts alike agree that until the cost factor is addressed, only those patients at highest risk for complications should expect to receive the newest medications. Medicaid may also require prior authorization and limit coverage to the sickest patients.

“In the valid effort to control the enormous cost of healthcare, could we be jeopardizing the very healthcare-funded innovations that previously contributed to our nation’s well-being?” asked Marc D. Grodman, MD, CEO of Bio-Reference Laboratories, Inc. “Unfortunately, the answer is yes, because we have yet to establish the balance between managing the cost to provide and access healthcare with maintaining the ability for development at all levels of the care spectrum.”
 
Around the Web

Should Healthier Patients Be Asked To Wait To Use Costly Hepatitis C Drugs? [Kaiser Health News]

Innovation Must be Part of the Cost Evaluation of Healthcare [The Hill]