Prevention of cirrhosis in hepatitis C with use of direct-acting anti-virals
The new direct-acting anti-virals (DAAs) for hepatitis C virus (HCV) infection offer higher cure rates, but at a much higher cost than the standard interferon-based treatments.
Faria R et al published a research article in PubMed titled :Prevention of progression to cirrhosis in hepatitis C with fibrosis: effectiveness and cost effectiveness of sequential therapy with new direct-acting anti-virals, with an aim to identify the cost-effective treatment for patients with HCV infection with F3 liver fibrosis who are at high risk of progression to cirrhosis.
When Direct Acting Antivirals (DAAs) were first approved for hepatitis C treatment in 2013, there were widespread fears that their high price would put them out of reach for the more than 80 million people with chronic hepatitis C infections worldwide.
The new medicines have a cure rate of over 95%, fewer side effects than previously available therapies, and can completely cure the disease within three months.
For the purpose of the study, the health benefits and costs of all currently licensed treatments as single treatments were compared with sequential therapy of up to three lines.
The researchers concluded that treatment before progression to cirrhosis always offers the most health benefits for the least costs. Sequential therapy with multiple treatment lines cures over 89% of patients across all HCV genotypes while ensuring a cost-effective use of resources. Cost-effective regimes for HCV genotype 1 patients include first-line oral therapy with sofosbuvir-ledipasvir while peginterferon continues to have a role in other genotypes. Thus the cost-effective treatment for HCV can be established using decision analytic modelling comparing single and sequential therapies. Sequential therapy with DAAs is effective and cost-effective in HCV patients with F3 fibrosis.
This information is of significant benefit to health care providers with budget limitations and provides a sound scientific basis for drug treatment choices.
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