Hepatitis C

The American Journal of Managed Care will host a two-day event September 25-26, 2014, to take on some of healthcare's biggest challenges: Treatments that cure hepatitis C are making news but upending balance sheets. A recent recommendation seeks preventive therapy to stop new cases of HIV. Hospitals and public health officials are grappling with how to prevent the spread of MERS. Only AJMC will bring payers, clinicians, policy leaders, and pharmaceutical representatives together to share ideas.

Specialty pharmaceuticals are currently the object of payer focus as one of the major drivers of increased pharmacy spending in 2014 and beyond.

Medicaid managed-care plans are demanding relief from state officials to meet mounting outlays for Gilead Sciences' wonder drug, while insurer WellPoint called Sovaldi its biggest watch item.

AJMC Panel Reviews Treatment, Cost Impacts of Emerging Shift to All-Oral Regimens With High Cure Rates

Doctors should consider expensive new hepatitis C drugs for patients with advanced liver disease, including those awaiting transplants, but ask most others to wait for drugs in development, the Department of Veterans Affairs said Wednesday.

Groundbreaking hepatitis C therapies represent a new era in treatment. But their cost is unprecedented, meaning health plans and PBMs are facing difficult formulary decisions.

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.

AJMC Panel Touts Shift from 'Chronic' to 'Cured' as FDA Gives Breakthrough Status to BMS All-Oral Combo Regimen

In the concluding segment, Dr Fendrick asks the panel to provide closing remarks about the future of treating hepatitis C (HCV). Dr Afdal says he believes this is a moment in time where a revolution is taking place.

Dr Fendrick says that while indication and utilization of major innovations should be widespread, there are still questions of who will pay for them. As mentioned, plan sponsors (employers) are only 1 option.

Dr Fendrick urges the panel to discuss which tools involving benefit design are being put into place to make sure that only those patients who would benefit most from new drugs are receiving them.

The panelists continue to debate whether hepatitis C virus (HCV) treatment should be administered by primary care physicians (PCPs) or hepatologists.

While some patients and physicians are not aware of the costs of care, others are concerned about whether they can afford treatment options at all. Dr Miller describes some of the major steps to the incremental benefits and incremental costs incurred by new agents.

Despite the relatively inexpensive 1-time tests to screen for hepatitis C virus (HCV), Dr Fendrick and the panel explore the concerns that plan sponsors may have regarding the costs of new specialty drugs made to treat HCV.

In this clip, the panel discusses the implications of health reform on the treatment of hepatitis C virus (HCV), including what is needed to improve outcomes. This includes educating primary care physicians about how the Affordable Care Act requires health plans to pay for the costs of testing and screening for risk factors of HCV.

Dr Mark Fendrick, University of Michigan, co-editor-in-chief, AJMC, moderates a discussion with Dr David Winston, section head of gastroenterology & hepatology, Cigna HealthCare of Arizona; Dr Steven Miller, chief medical officer, Express Scripts; and Dr Nezam H. Afdhal, associate professor of medicine, Harvard School of Medicine, chief of hepatology, director of Liver Center, Beth Israel Deaconess Medical Center.

In an integrated health system, human immunodeficiency virus and hepatitis C telemedicine clinics are associated with improved access, high patient satisfaction, and reduction in health visit“related time.