Pricey Hepatitis Drug a Good Bet in U.S. Prisons, Study Says

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Using an expensive drug to treat prison inmates with hepatitis C is more cost-effective than another treatment option, according to a new study.

More than 500,000 prison inmates in the United States have hepatitis C, which causes liver damage. It’s spread by contact with infected blood.

The drug Sovaldi (sofosbuvir) costs more than $7,000 a week for 12 weeks of treatment. Some states are concerned about the price and want to limit its use in prisons.

However, “it looks like the additional benefits of sofosbuvir are sufficiently large even in this high-risk population to justify its increased cost,” study senior author Jeremy Goldhaber-Fiebert, an assistant professor of medicine at the Stanford School of Medicine, said in a university news release.

Until a few years ago, hepatitis C patients were treated over 48 weeks with two drugs, pegylated interferon and ribavirin. The treatment — effective in less than half of patients — caused fatigue, nausea and headache, along with many other side effects, according to the news release.

In 2011, the U.S. Food and Drug Administration approved a new hepatitis C drug called Victrelis (boceprevir) which, when used with pegylated interferon and ribavirin, was more effective than that two-drug combination, but more expensive.

Sovaldi was approved by the FDA in 2013 but costs more than Victrelis.

In this study, Stanford University researchers used a computer program to compare the cost and effectiveness of treating a hypothetical group of hepatitis C-infected prison inmates with either 28 weeks of Victrelis plus pegylated interferon and ribavirin, or 12 weeks of Sovaldi plus pegylated interferon and ribavirin.

Compared to no treatment, the Sovaldi treatment added 2.1 quality-adjusted life years at an additional cost of $54,000, while the Victrelis treatment added 1.3 quality-adjusted life years, according to the study published Oct. 21 in the Annals of Internal Medicine.

Quality-adjusted life years, or QALYs, is a method used to measure the effectiveness of a treatment over time. For example, a treatment that adds one year of optimal health to a patient’s life equals one QALY. A treatment that provides half that quality of health for an additional two years also would equal one QALY.

However, concerns about the affordability of Sovaldi still remain due to its high cost, Goldhaber-Fiebert added.

“Though often not the focus of health-policy research, [hepatitis C]-infected inmates are a population that may benefit particularly from a highly effective, short-duration treatment,” Goldhaber-Fiebert said.

More information

The U.S. National Institute of Allergy and Infectious Diseases has more about hepatitis C.

Source: HealthDay

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