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HCV-infected patients need access now to new direct-acting antiviral agents to avert liver-related deaths

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To the Editor: We recently used a modelling approach to describe how the burden of infection with hepatitis C virus (HCV) and the associated health care costs in Australia will increase as the infected population ages.1 We showed that increasing the efficacy of antiviral therapy and the number of patients treated could avert the expected increase in deaths from HCV-related liver disease and in the number of patients with end stage HCV-related liver disease. We did not include the specific costs of new direct-acting antiviral (DAA) regimens, as these are yet to be determined in Australia. We know that the cost of the new regimens has elicited discussion internationally about the ability of payers to meet those costs.

Importantly, compared with previous regimens, DAA therapies offer higher cure rates, simplified dosing, shorter treatment duration and are better tolerated — albeit at a substantial price.

Given the difficult decisions that will need to be made by the Australian Government, we examined the impact of delayed access to DAA treatment by modelling 1-year and 2-year delays. Currently, an estimated 2550 patients are treated with interferons and/or first-generation protease inhibitors.1 In the DAA scenario, we assumed cure rates of over 90%, drug availability in 2015 and an increase in the number of patients treated to 3550…