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The cost of treating people infected with the hepatitis C virus (HCV) with newly approved therapies will likely place a tremendous economic burden on the country¡¯s health care system.

The prediction comes from a cost-effectiveness analysis led by researchers at MD Anderson. The findings, reported in the Annals of Internal Medicine, predict that the cost of providing patients their daily regimens could total $90 billion over five years.

Jagpreet Chhatwal, Ph.D., study lead and assistant professor of Health Services Research, reported a combination of two drugs ¡ª sofosbuvir and ledipasvir ¡ª recently approved by the U.S. Food and Drug Administration to treat hepatitis C ¡ª is cost-effective compared to the old standard of care. The budget needed to treat all diagnosed patients, however, is unsustainable.

¡°We have millions of people who need treatment for hepatitis C and payers obviously don¡¯t have the budget to cover this tremendous expense,¡± says Chhatwal. As a result, physicians have to prioritize the new drugs to the sickest of patients, and several payers have added restrictions that only those with the most advanced disease receive treatment.¡±

More than 2 million people are infected with HCV, a virus found in the liver that can cause liver cancer. It is transmitted through blood-to-blood contact.

Study results showed that using the new drugs is cost-effective in the majority of patients. However, the budget required to treat all eligible patients would be $90 billion over the next five years. Compared with the old drugs, new therapies would cost an additional $20 billion, whereas the cost offsets would be only $16 billion.

¡°While most developed countries factor in treatment cost before approving a drug, U.S. law prohibits considering such costs. Therefore, patients almost always end up paying more for the drugs that were developed in the U.S.,¡± Chhatwal explains. ¡°Considering the law also prohibits Medicare from negotiating drug pricing, the new treatment cost could strain the Centers for Medicare and Medicaid Services budget.¡±

Economics need to play an important part of improving the health care system, Chhatwal said.

¡°Hepatitis C presents an unusual case where we have cost effective therapeutic options that our health care system cannot afford,¡± he continued. ¡°While lower drug prices will help, that¡¯s not sufficient. Both the government and private insurers will need additional resources to effectively manage this epidemic.¡±