When Delaying Treatment Could Cost You More Dough

Hepatitis C treatment was most cost-effective when started early

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) The cost of treating a chronic disease can add up, sometimes leading patients to hold off until the disease progresses. The most cost-effective way to treat a common liver condition, however, might be to face it head on.

A new study looked at the cost-effectiveness of treating hepatitis C and found that immediate treatment even in patients with only moderately advanced disease was a cost-effective route.

"New treatments for hepatitis C virus (HCV) may be highly effective but are associated with substantial costs that may compel clinicians and patients to consider delaying treatment," explained the authors of this new study, led by John W. Ward, MD, director of the Division of Viral Hepatitis at the Centers for Disease Control and Prevention (CDC) in Atlanta.

Hepatitis C is a liver disease spread through infected blood. The disease can lead to issues like liver scarring (cirrhosis) and liver cancer.

The CDC estimated that there are 3.2 million chronic hepatitis C patients in the US — many of whom may not know they are infected. Several medications can help treat the disease.

However, Dr. Ward and team explained that some guidelines suggest that only patients with more advanced liver inflammation or cirrhosis need to begin treatment right away. These researchers wanted to look at the cost-effectiveness of hepatitis C treatments among patients with less advanced disease. They looked at both the cost of treatment and the quality of life of patients.

Dr. Ward and team looked at data from a number of sources, such as the large Chronic Hepatitis Cohort Study, to construct a model, or scenario, involving a 55-year-old patient and the assumption that treatment is 90 percent effective and would cost $100,000.

In this scenario, the patient had moderate liver fibrosis (scarring). Immediately starting treatment amounted to a cost-effectiveness of $37,000 per every year of increased quality of life — a cost-effective route, Dr. Ward and team noted.

These researchers found that in some scenarios, treating patients with no liver damage or very minimal damage was less cost-effective, but it became more cost-effective when they assumed a lower cost of treatment.

Based on this data, Dr. Ward and colleagues said that starting treatment immediately for patients with even moderate disease progression appeared to be a cost-effective approach.

"The devastating effects of hepatitis C continue to threaten the health of many Americans, with baby boomers at particular risk," Dr. Ward said in a press release. "This analysis of treatment available for hepatitis C describes specific scenarios when immediate or earlier treatment can be both cost-effective and increase quality of life."

This study did not take into account other health problems patients might have, which could affect results, Dr. Ward and team noted.

This study was published online March 16 in the journal Hepatology.

Abbott Laboratories, Vertex Pharmaceuticals and the CDC funded this research. Dr. Ward and team disclosed no conflicts of interest.

Review Date: 
March 17, 2015
Last Updated:
March 17, 2015