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Assessing the Value of New Treatments for Hepatitis C: Are International Decision Makers Getting this Right?


  • Beth Woods

    (University of York)

  • Rita Faria

    (University of York)

  • Susan Griffin

    (University of York)


Health systems worldwide are facing difficult choices about the use of a series of highly effective but costly new treatments for hepatitis C. In this paper we discuss how the National Institute for Health and Care Excellence in England and Wales, the Common Drug Review in Canada and the Pharmaceutical Benefits Advisory Committee (PBAC) in Australia have approached the appraisal of these drugs. We argue that with the exception of the PBAC, assessments of the new drugs have not adequately accounted for their large financial burden. Given the potential health system impact of reimbursing these drugs, the use of lower cost-effectiveness thresholds should be considered. None of the decision-making processes included a comparison of the full range of treatment pathways. In particular, comparisons of using the new drugs as first- versus second-line drugs were omitted from all appraisals, as were comparisons with delayed treatment strategies whereby treatment is withheld until more severe disease stages. Omission of comparators leads to inaccurate estimates of cost effectiveness and potentially sub-optimal decision making. Lessons learned from these appraisals should be considered in future appraisals, particularly the upcoming assessments of the ‘blockbuster’ PCSK9 inhibitors for hypercholesterolaemia.

Suggested Citation

  • Beth Woods & Rita Faria & Susan Griffin, 2016. "Assessing the Value of New Treatments for Hepatitis C: Are International Decision Makers Getting this Right?," PharmacoEconomics, Springer, vol. 34(5), pages 427-433, May.
  • Handle: RePEc:spr:pharme:v:34:y:2016:i:5:d:10.1007_s40273-015-0369-5
    DOI: 10.1007/s40273-015-0369-5

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    Blog mentions

    As found by, the blog aggregator for Economics research:
    1. Rita Faria’s journal round-up for 22nd October 2018
      by Rita Faria in The Academic Health Economists' Blog on 2018-10-22 11:00:09


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    Cited by:

    1. Barbara de Graaff & Kwang Chien Yee & Philip Clarke & Andrew Palmer, 2018. "Uptake of and Expenditure on Direct-Acting Antiviral Agents for Hepatitis C Treatment in Australia," Applied Health Economics and Health Policy, Springer, vol. 16(4), pages 495-502, August.
    2. Alexis Llewellyn & Rita Faria & Beth Woods & Mark Simmonds & James Lomas & Nerys Woolacott & Susan Griffin, 2016. "Daclatasvir for the Treatment of Chronic Hepatitis C: A Critique of the Clinical and Economic Evidence," PharmacoEconomics, Springer, vol. 34(10), pages 981-992, October.
    3. Torbjørn Wisløff & Richard White & Olav Dalgard & Ellen J. Amundsen & Hinta Meijerink & Astrid Louise Løvlie & Hilde Kløvstad, 2018. "Economic Evaluation of Direct-Acting Antivirals for Hepatitis C in Norway," PharmacoEconomics, Springer, vol. 36(5), pages 591-601, May.
    4. Max J. Korman & Kjetil Retterstøl & Ivar Sønbø Kristiansen & Torbjørn Wisløff, 2018. "Are PCSK9 Inhibitors Cost Effective?," PharmacoEconomics, Springer, vol. 36(9), pages 1031-1041, September.
    5. Sebastian Hinde & Louise Horsfield & Laura Bojke & Gerry Richardson, 2020. "The Relevant Perspective of Economic Evaluations Informing Local Decision Makers: An Exploration in Weight Loss Services," Applied Health Economics and Health Policy, Springer, vol. 18(3), pages 351-356, June.

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