Pharmacists Need to Weigh Cost-Benefit of Hepatitis C Drugs

The total cost of health must be considered in light of a potential cure.

High costs associated with new chronic hepatitis C virus (HCV) treatments should prompt pharmacists to reconsider their formula for determining the drugs’ worth.

“The [health care] landscape has a lot of activity in terms of antivirals—primarily for hepatitis C,” Tom Frank, PharmD, BCPS, director of research and education at University of Arkansas Medical Sciences Area Health Education Center told Pharmacy Times in an exclusive interview at the American Society of Health-System Pharmacists (ASHP) 2015 Summer Meetings and Exposition in Denver.

A large portion of Dr. Frank’s “New Drugs in Primary Care” session at ASHP focused on 2 new HCV drugs, sofosbuvir (Sovaldi) and ledipasavir/sofosbuvir (Harvoni)—examples of this year’s “incredibly innovative drugs” that “almost across the board have price tags associated with them that are challenging,” he explained.

Sovaldi’s cost per patient is $80,000 for 12 weeks of treatment, while Harvoni’s is $1130 per daily tablet for 12 weeks in HCV genotype 1 patients or 24 weeks in HCV genotype 1 patients with cirrhosis.

Both drugs’ high price tags must be factored into the “big picture” equation for treating chronic HCV, Dr. Frank said. Notably, the clinical trials of each yielded very promising results.

“Sovaldi is to hepatitis C what penicillin was to pneumonia at the time,” Dr. Frank told ASHP attendees. “It’s a line in the sand. A game changer.”

Because of the high cure rates associated with Sovaldi and Harvoni, pharmacists should “look at the total cost of health” with respect to the drugs’ potential to impact patient outcomes, Dr. Frank explained to Pharmacy Times.

“Though they might appear to be expensive in terms of…the health-system budget, [these HCV drugs] may have a very decent value because the patient is either not on inpatient status or they’re with a particular treatment that takes a chronic condition and causes it to go away,” he said.

The drugs’ high costs will likely draw more players to the HCV market space, Dr. Frank told attendees. He forecasted that, by this time next year, there could be 10 or 12 new chronic HCV drugs.