The oncogenic effects of the hepatitis C virus can impact patient outcomes for hepatocellular carcinoma (HCC) and have economic implications for medical spending. This study underscores the importance of treating patients early in the disease process for savings associated with reducing the risks of HCC.
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Published Online: April 20, 2017S.
Mantravadi, PhD, MS, MPH
The hepatitis C virus (HCV) is an oncogenic virus that is the primary risk factor for hepatocellular carcinoma (HCC), illustrating the relative importance of tertiary prevention of liver cancer.1,2 Health disparities in HCV indicate its disproportionate prevalence among low-income populations. Due to low efficacy rates, predominant treatment regimens do not significantly prevent disease progression toward HCC among all populations—although the risk of HCV is higher in the Medicaid population. Direct-acting antivirals (DAAs) result in improved efficacy and ease of administration compared with current hepatitis treatment options.
Methods: Published literature and the Medicaid National Average Drug Acquisition Cost were used to estimate treatment costs, and averted medical HCC costs were modeled for DAAs and prevailing treatment options for HCV.
Results: Approximately $14,473 in medical expenses related to HCC treatment per person can be avoided over the next 10 years with the sofosbuvir-ledipasvir combination treatment for cirrhotic Medicaid beneficiaries infected with HCV genotype 1a. The DAAs result in lower HCC-related medical spending costs than peginterferon-ribavirin and watch-and-wait regimens.
Conclusions: The oncogenic effects of HCV can impact patient outcomes for HCC and have economic implications for medical spending. The study provides evidence that underscores the importance of treating patients early in the disease process to reap savings related to reduced risks of HCC.