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Drug Pricing Evolution in Hepatitis C

Author

Listed:
  • Nathalie Vernaz
  • François Girardin
  • Nicolas Goossens
  • Urs Brügger
  • Marco Riguzzi
  • Arnaud Perrier
  • Francesco Negro

Abstract

Objective: We aimed to determine the association between the stepwise increase in the sustained viral response (SVR) and Swiss and United States (US) market prices of drug regimens for treatment-naive, genotype 1 chronic hepatitis C virus (HCV) infection in the last 25 years. We identified the following five steps in the development of HCV treatment regimens: 1) interferon (IFN)-α monotherapy in the early '90s, 2) IFN-α in combination with ribavirin (RBV), 3) pegylated (peg) IFN-α in combination with RBV, 4) the first direct acting antivirals (DAAs) (telaprevir and boceprevir) in combination with pegIFN-α and RBV, and 5) newer DAA-based regimens, such as sofosbuvir (which is or is not combined with ledipasvir) and fixed-dose combination of ritonavir-boosted paritaprevir and ombitasvir in combination with dasabuvir. Design: We performed a linear regression and mean cost analysis to test for an association between SVRs and HCV regimen prices. We conducted a sensitivity analysis using US prices at the time of US drug licensing. We selected randomized clinical trials of drugs approved for use in Switzerland from 1997 to July 2015 including treatment-naïve patients with HCV genotype 1 infection. Results: We identified a statistically significant positive relationship between the proportion of patients achieving SVRs and the costs of HCV regimens in Switzerland (with a bivariate ordinary least square regression yielding an R2 measure of 0.96) and the US (R2 = 0.95). The incremental cost per additional percentage of SVR was 597.14 USD in Switzerland and 1,063.81 USD in the US. Conclusion: The pricing of drugs for HCV regimens follows a value-based model, which has a stable ratio of costs per achieved SVR over 25 years. Health care systems are struggling with the high resource use of these new agents despite their obvious long-term advantages for the overall health of the population. Therefore, the pharmaceutical industry, health care payers and other stakeholders are challenged with finding new drug pricing schemes to treat the entire population infected with HCV.

Suggested Citation

  • Nathalie Vernaz & François Girardin & Nicolas Goossens & Urs Brügger & Marco Riguzzi & Arnaud Perrier & Francesco Negro, 2016. "Drug Pricing Evolution in Hepatitis C," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-12, June.
    • Handle: RePEc:plo:pone00:0157098
    DOI: 10.1371/journal.pone.0157098
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    References listed on IDEAS

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    1. Nathalie Vernaz & Guy Haller & François Girardin & Benedikt Huttner & Christophe Combescure & Pierre Dayer & Daniel Muscionico & Jean-Luc Salomon & Pascal Bonnabry, 2013. "Patented Drug Extension Strategies on Healthcare Spending: A Cost-Evaluation Analysis," PLOS Medicine, Public Library of Science, vol. 10(6), pages 1-11, June.
    2. Katelijne Vooren & Silvy Duranti & Alessandro Curto & Livio Garattini, 2014. "A Critical Systematic Review of Budget Impact Analyses on Drugs in the EU Countries," Applied Health Economics and Health Policy, Springer, vol. 12(1), pages 33-40, February.
    3. Alena M Pfeil & Oliver Reich & Ines M Guerra & Sandrine Cure & Francesco Negro & Beat Müllhaupt & Daniel Lavanchy & Matthias Schwenkglenks, 2015. "Cost-Effectiveness Analysis of Sofosbuvir Compared to Current Standard Treatment in Swiss Patients with Chronic Hepatitis C," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-20, May.
    4. Katelijne Vooren & Alessandro Curto & Livio Garattini, 2015. "Pricing of forthcoming therapies for hepatitis C in Europe: beyond cost-effectiveness?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(4), pages 341-345, May.
    5. DiMasi, Joseph A. & Hansen, Ronald W. & Grabowski, Henry G., 2003. "The price of innovation: new estimates of drug development costs," Journal of Health Economics, Elsevier, vol. 22(2), pages 151-185, March.
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    1. Amandine Garcia & Sascha Moore Boffi & Angèle Gayet-Ageron & Nathalie Vernaz, 2019. "Access to unauthorized hepatitis C generics: Perception and knowledge of physicians, pharmacists, patients and non-healthcare professionals," PLOS ONE, Public Library of Science, vol. 14(10), pages 1-14, October.

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