Hepatitis C-Infected Livers Still Viable, Cost Effective for Transplants

As evidence mounts that it’s safe to transplant the livers of hepatitis C (HCV)-positive donors into HCV-negative patients, a new study finds the practice is also more cost-effective than waiting for a non-HCV-infected donor liver.

Researchers from the University of Pennsylvania earlier this year announced findings showing that patients who received a liver transplant from an HCV-infected donor could be cured of HCV and that their new livers would function just as well as livers donated by HCV-negative patients. New research is now adding to the conversation.

Scientists from several US academic medical institutions have published a study showing that it’s cost-effective to use the livers of HCV-positive patients. Cost is a major issue because the price for direct-acting antiviral therapy is upwards of $100,000, and a recent study found that in about half of cases, HCV-positive patients are denied coverage for DAAs.

“The added cost of DAA in this setting remains a logistical barrier,” Jagpreet Chhatwal, PhD, the corresponding author on the new cost-effectiveness study, told MD Magazine®. “Payers currently do not approve DAA treatment for patients who acquire HCV infection resulting from an HCV-positive liver transplant.”

For their study, Chhatwal and colleagues looked specifically at costs and benefits when patients receiving HCV-positive livers were given pre-emptive direct-acting antiviral (DAA) therapy. The team adapted a Markov-based mathematical model to conduct a “virtual trial” of patients on the national liver transplant waiting list. The cost was calculated based on 12 weeks of DAA therapy.

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