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New Opportunities and Challenges in Hepatitis C

Hepatitis C is an enormously common disease that is often initially asymptomatic. New drugs are very effective, but expensive, and there has been reluctance to cover these treatments. Authors that published research in the hepatitis C special issue present their findings.

Darius Lakdwalla, PhD, gave attendees a better understanding of "the dismal science of economics" as it relates to the HCV cures. Since hepatitis C is largely asymptomatic for a number of years, it takes a while for the benefit of treatment to accrue, he explained.

"If you compare people who are successfully treated, essentially cured with no viral load in their body, and compare them to other people with hepatitis C, who still are infected with the virus, over the first couple of years there's not a really big difference in death rates among those 2 populations," he explained.

It takes about 15 years or more to start to see a difference, Lakdawalla said. Unfortunately, many of the people infected with HCV are covered by private insurance or Medicaid, and this is an economic problem because neither of those entities cover people for very long.

"So think about this: we've got a disease where the cost of it manifests long into the future ... 10, 15 years down the road," he said. "But private payers typically are only covering people for about 3 or 4 years. So that creates a significant problem where the payer that has to bear the cost of paying for the treatment doesn't stick around long enough to see the benefits in the future."

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