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Gastroenterology Blog

Hepatitis C Treatment Debate: How the Cost of Sovaldi Will SAVE Insurance Company's Money

Posted by Gastroenterology Associates on Thu, Sep 25, 2014 @ 2:56 PM

Sovaldi, the recently released cure for hepatitis C, has garnered a great deal of controversy due to its high cost. The drug is one of the most expensive available, at $1,000 per pill or a total of $84,000 per course of treatment. Sovaldi is expensive for both insurance companies and patients - but, as John LaMattina argues in Forbes, it is still expected to result in considerable savings for insurance companies and patients.

The Cost of Hepatitis C

hepatitis C debateHepatitis C is a virus that can cause severe damage to the liver. It is relatively common in the United States, and there is no vaccine and up until recently there was no cure. Chronic hepatitis C develops in people who are unable to fight the virus off, which causes the virus to stay in the body over a period of many years. The disease is one of the most common causes of cirrhosis and liver failure in the United States.

Prior to the development of Sovaldi, treatment of hepatitis C was largely symptomatic as the disease progressed. Hepatitis C is one of the leading causes of liver transplantation in the United States, and the bill is big: a liver transplant from a non-living donor can cost around $300,000, while a transplant from a living donor is even more. In addition, hepatitis C is a chronic disease that requires long-term, intensive care that goes beyond the cost of an organ transplant. 

Apart from the cost, organ transplantation has other downsides that make it less than ideal as a treatment for any disorder. During and after the surgery, there is a significant potential for (expensive) complications to develop. If the liver donation comes from a living donor, the donor may also develop complications during or after the surgery. The recipient must take drugs to suppress transplant rejection over a long period of time, which can result in additional complications on the receiving end.

 Although receiving a transplant is life-saving for many people, it is still not an ideal or perfect treatment, especially if it could be avoided by other means of treatment.

Sovaldi Savings

At $84,000 for a full course of treatment, Sovaldi costs much less than liver transplantation even though it costs much more than most drugs. Despite the price difference between the cost of Sovaldi and the cost of traditional treatment for hepatitis C, insurance companies have been vocal in their outcry regarding the high cost of treatment. According to insurance companies, curing all 3 million hepatitis C patients would bankrupt the health care system. The use of Sovaldi is expected to increase the amount of spending on hepatitis C drugs by 209% in the next year.

Despite these concerns, the situation may not be so dire. Research from the PwC Health Research Institute suggests that the cost of curing hepatitis C with Sovaldi would indeed increase healthcare costs in the immediate future, reaching a peak in 2016. After this peak, the amount of spending on hepatitis C would decline within a decade.

The savings will occur for several reasons. As hinted at above, the cost of treating hepatitis C with this expensive drug regimen is nevertheless still more affordable than treating the disease with liver transplants and providing long-term care for a chronic illness. In addition, curing the disease will help with the lost productivity that occurs as a result of chronic illness.

Sovaldi is in a small class of drugs that actually provides a long-term cure for an illness rather than treating symptoms or extending life in the short-term only. Given the immense benefits of this life-saving drug, future efforts to reduce costs should focus on identifying patients most in need of treatment versus patients who would not benefit from immediate treatment with Sovaldi.

Baton Rouge and Hepatitis C

The team of doctors at Gastroenterology Associates is beginning a huge push to make the age group most at risk for Hepatitis C aware of the potential for silent damage to occur. 

A large cohort of infected individuals with hepatitis C is unaware that they are even infected.  The typical individual in this demographic is of Baby Boomer age and may have high risk factors such as blood transfusions before 1992, shared needles usage, birth from an infected mother, and less commonly, sexual or blood contact. 

Due to the asymptomatic / silent nature of the disease, sometimes hepatitis C has been present for several years before a diagnosis is made, hence the risk of developing chronic liver disease such as cirrhosis by then.  It is important to get tested for hepatitis C, possibly in conjunction with your regular colorectal cancer screening, so that proper treatment regimens can be started before any major damage is endured

Hepatitis C treatments have seen such progressive strides recently with the availability of Sovaldi, but individuals with infected that are unaware may be suffering damage to their liver. Contact your doctor at Gastroenterology Associates to schedule your testing or treatment options for hepatitis C.

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Disclaimer: All information provided in this article is for informational purposes only and should not replace the consultative advice and experienced feedback from your physician.    Always consult with your physicians on any of your questions and concerns.