Though the effectiveness of the newer hepatitis C treatments is impressive by curing many people who are infected with the hepatitis C virus (HCV), there is still so much to be done in order to eliminate HCV from the general population. Data presented at the 2015 Annual Liver meeting suggest that continued screening for Hepatitis C is critical in eliminating the spread of the virus.1,2
In fact, data suggest that even after the year 2020, there will still be approximately half a million people who are infected with hepatitis C who don’t know it. Jagpreet Chhatwal, PhD, from the Massachusetts General Hospital and Harvard Medical School in Boston, stated that “we need aggressive screening and treatment policies to further reduce the burden of hepatitis C.”
Dr. Chhatwal and his colleagues used a Hepaitis C Disease Burden Simulation model they developed to examine patient demographics, disease characteristics, therapeutics, screening policies, insurance coverage, and access to treatment in the US.3
While treatments, including the new direct-acting antivirals (DAAs) are projected to reduce the number of hepatitis C deaths by more than half from 2015 to 2050, it’s possible that approximately 317,000 will still die from HCV during that time period.
There are currently ~2 million non-institutionalized people who are chronically infected with hepatitis c, and of those, about 1.1 million know that they are infected and have insurance, but most of them are still not being treated. While examining data for drug sales, it’s estimated that in 2014, only approximately 140,000 patients were treated, and this year that number will only increase to about 180,000.
At this rate, it will take at least 10 years before the number of treatment candidates is below 50,000, Dr. Chhatwal reported. He noted that, “We can treat more than 180,000. We want to send a message that if we can increase the number of people getting treated, then we can reduce the disease burden.”
Dr. Chhatwal and his colleagues also examined the trends in cost of care for patients with Hepatitis C, and found that it increased from $7 billion before the introduction of DAAs to $21 billion in 2015. While that cost will presumably decrease as the prevalence of HCV declines, it is estimated that it will cost $106 billion over the course of the next 25 years to make hepatitis C a rare disease.
Gyongyi Szabo, MD, PhD, who is the president of the American Association of the Study of Liver Diseases (AASLD), noted that this disease burden can be reduced by having primary care providers screen more patients for the virus. The CDC currently recommends that everyone born between 1945 and 1965 should be tested for HCV.
Harrison L. New Treatments Not Enough to Eliminate Hepatitis C. Medscape Medical News. November 17. 2015. Available at: http://www.medscape.com/viewarticle/854624
The Liver Meeting 2015: American Association for the Study of Liver Diseases (AASLD). Abstract 104. Presented November 16, 2015.
Kabiri M, et al. The Changing Burden of Hepatitis C Infection in the United States: Model-based Predictions. Ann Intern Med. 2014;161:170-180.