Hepatitis C Treatment for Patients Without Liver Damage May Not Be Cost Effective, Study Says
People with hepatitis C who do not have liver damage may not benefit from beginning treatment early because of the potentially severe side effects of the drugs, the "hefty cost" of treatment and the chance that treatment could be ineffective, according to a study published in the July 9 issue of the Journal of the American Medical Association, the Newark Star-Ledger reports (Stewart, Newark Star-Ledger, 7/9). Researchers from the Harvard School of Public Health's Center for Risk Analysis examined U.S. health data for people with hepatitis C. There are 2.7 million people with chronic hepatitis C in the United States, and 25,000 new cases are reported annually. Most hepatitis C patients do not develop liver damage before dying of other causes, Reuters reports. Researchers found that over a 30-year period the chance of developing cirrhosis, or inflammation of the liver, for men with hepatitis C is between 13% and 46%, and female patients' chances ranges between 1% and 29% (Reuters, 7/8). In addition, three injections per week of interferon and oral ribavirin cost $20,000 per person for the 48-week course of treatment (Newark Star-Ledger, 7/9). Hepatitis C patients experienced treatment benefits "largely in the form of improvements in health-related quality of life," instead of prolonged life, according to the study. Therefore, although newer hepatitis C treatments seem to be "reasonably cost-effective on average," the study's findings "vary widely" across different patient subgroups and "depend critically on quality-of-life assumptions," according to the authors. The researchers concluded, "As the pool of persons eligible for treatment for [hepatitis C] expands to the more general population, it will be imperative for patients and their physicians to consider these assumptions in making individual-level treatment decisions" (Salomon et al., JAMA, 7/9).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.