RESUMO
Treatment of chronic hepatitis C (HCV) has changed dramatically since the approval of the direct-acting antivirals (DAA). Depending on the HCV genotype and the stage of liver disease, sustained HCV clearance can be achieved in more than 95% of patients with a treatment duration of 8-12 weeks in most of the cases. The selection and combination of the drugs depends on previous antivirals therapies, the stage of liver fibrosis, HCV genotype and subtype, viral load at baseline, and renal function. Nowadays, potent antiviral therapy with minimal side effects can be offered to almost every patient. In the real-world setting, a high quality of HCV therapy considering economic aspects has been documented in the German Hepatitis C Registry. A reduction of clinical complications of chronic liver disease by clearance of HCV has already been documented.
Assuntos
Algoritmos , Antivirais/uso terapêutico , Hepatite C Crônica/tratamento farmacológico , Antivirais/efeitos adversos , Antivirais/economia , Custos de Medicamentos/estatística & dados numéricos , Alemanha , Hepatite C Crônica/economia , Humanos , Cirrose Hepática/tratamento farmacológico , Cirrose Hepática/economia , Programas Nacionais de Saúde/economia , Inibidores de Proteases/efeitos adversos , Inibidores de Proteases/uso terapêutico , Sofosbuvir/efeitos adversos , Sofosbuvir/economia , Sofosbuvir/uso terapêutico , Proteínas não Estruturais Virais/antagonistas & inibidoresRESUMO
Given the recent approval of the first pan-genotypic chronic hepatitis C virus (HCV) therapy, managed care, health systems, and clinicians will need to evaluate current practices related to essential laboratory assessments used to select therapy. Historically, clinicians and payers required a battery of tests to determine HCV genotype, viral load, degree of fibrosis, and organ function. In light of current and forthcoming approvals of pan-genotypic therapy, clinicians and payers can expect a more competitive marketplace and a downward curve in the price of therapy. Ultimately, this development will lead to the cost of screenings and assessments having an increased role in selecting an optimal HCV therapy. DISCLOSURES: No outside funding supported this study. The authors have nothing to disclose. All authors contributed to study concept and design. Calabrese took the lead in data collection, along with Shaya. Data interpretation was performed by Calabrese and Hynicka, along with Rodriguez de Bittner and Shaya. The manuscript was written and revised by Calabrese and Hynicka, along with Rodriguez de Bittner and Shaya.