Pricey new hepatitis C drugs could yield economic benefits

Last Updated: 2015-05-18

By Megan Brooks

NEW YORK (Reuters Health) - The new higher-priced hepatitis C drugs that hit the market recently could generate huge cost savings in terms of worker productivity for societies that don't shy away from them, according to an economic analysis presented May 17 at Digestive Disease Week 2015.

The all-oral combination of ledipasvir and sofosbuvir (Harvoni, Gilead Sciences) is significantly more expensive than the older standbys (ribavirin and interferon). But they have proven safer and more effective in clinical trials, and the new analysis shows that that could generate savings in the billions annually in the United States and five European countries.

More specifically, "investing in new (hepatitis C) therapies could result in annual savings of more than $3.2 billion in the United States and five European countries," lead investigator Dr. Zobair Younossi, chairman of the department of medicine at Inova Fairfax Medical Campus in Falls Church, Virginia, said during a conference media briefing.

"From a clinical standpoint, we've long known about the devastating health impacts that chronic hepatitis C has on a patient," Dr. Younossi, who has been a consultant to Gilead, added in a conference statement.

"But given the significant side-effects previously associated with treating the disease, notably fatigue and neuropsychiatric side effects, we were interested in looking at the impact of new treatments on patients' ability to work, and in a broader sense, how this effects employers and overall economies," he explained.

The research team analyzed self-reported data on workplace productivity from more than 1,900 patients with genotype 1 chronic hepatitis C who received the ledipasvir/sofosbuvir combination in clinical trials conducted in the U.S. and five European countries. The medication, which was approved in the US in 2014, has a cure rate of between 94% and 99% with minimal side effects. Gilead Sciences provided funding for the economic analysis.

The higher cure rate and lessened side effect profile of the combination translates into fewer days absent from work and improved workplace productivity, Dr. Younossi and colleagues found.

Specifically, their economic model suggests that reduced absenteeism and increased "presenteeism" (a measure of how productive an individual actually is at work) would generate roughly $2.67 billion for the United States and $556 million for the five European countries (France, Germany, Italy, Spain and the United Kingdom).

The model also predicted an average work productivity loss of $4,954 per employed patient per year due to chronic hepatitis C in the US and $1,129 per employed patient per year in the five European countries.

"Chronic hepatitis C is more than just a problem for the patient -- it has a ripple effect that impacts society at large. While previous reports have found the cost of these drugs as certainly significant, the long term benefits of curing patients with hepatitis C makes this a worthwhile investment. We must begin to look at chronic diseases, such as hepatitis C, from every angle, which should inspire progress in developing more tolerable and effective cures," Dr. Younossi said in the news release.

This analysis suggests that well-tolerated hepatitis C treatment regimens with high cure rates improve work productivity and "could make a substantial positive economic contribution. This indirect economic gain must be considered when assessing the full benefits" of treating chronic hepatitis C, the authors conclude in their meeting abstract.

Given that these data were derived from the clinical trials, the investigators plan further research to look at data outside clinical trials "in order to establish and evaluate the real-world consequences of hepatitis C cure on workplace productivity," Dr. Younossi noted.