New HCV Guidance: Rapid Updates for Clinicians

Laura A. Stokowski, RN, MS, Helen W. Boucher, MD; Paul Martin, MD


March 21, 2014

In This Article

The Cost of Treatment

Medscape: In the guidance document, you don't mention cost of treatment at all. It is understandable that you wouldn't want to get into that, but would you be willing to comment on the reports about the high cost of these drugs?

Dr. Martin: It is fair to say that the more treatment options that there are, the more price pressure there will be on the individual companies to license or sell their drugs at a competitive price. It is very expensive to take care of a patient with advanced liver disease -- not just the cost of a liver transplant, but a patient with advanced liver disease who is in and out of hospital with one complication after another is enormously resource-intensive for the system. If we can abort the progression of liver disease, we are ultimately going to have a major impact on healthcare costs related to hepatitis C. Many patients with hepatitis C may elect to wait for less expensive regimens if their liver disease is mild.

Medscape: Is there anything else practice-changing about the guidance document, as it stands today, that you would like to mention?

Dr. Martin: It is critically important that patients are seen by practitioners who are comfortable managing and treating hepatitis C. We don't want to restrict anyone from taking care of these patients, but we want to make sure that patients have the appropriate work-up. Patients with advanced liver disease who may need additional consideration, such as a liver transplant, should be referred for specialty care. Another group of patients who might need referral are those who are coinfected with HIV, who might need expertise in HIV management.

Dr. Boucher: We hope that primary care practitioners will use the guidance to help them decide who needs a referral and when.

Medscape: How do you plan to disseminate the guidance to clinicians, both now and when there is updated guidance that you want to make them aware of?

Dr. Boucher: I believe that the plan is to use the Website as the major point of dissemination.


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