How much does hepatitis C treatment cost?

By Rachel Nall, RN, MSN   

Reviewed by Jill Seladi-Schulman, PhD

How much is it? | Drug types and costs | Tracking costs | Insurance No insurance | Takeaway.

There is no vaccine to prevent hepatitis C, but medical innovations in recent years mean that oral treatments can cure most people. However, these newer drugs have a high cost that can make paying for hepatitis C treatment difficult.

This article details information about hepatitis C medications, and how, under certain circumstances, people may be able to access help to pay for them.

How much is the treatment?

Medication pricing is complex. When new medications hit the market, they are more expensive than older ones.

The medications do not have competition from other drug manufacturers, and pharmaceutical companies can control their distribution.

Over time, as companies release competitor medications or the medicine is available as a generic drug, the competition usually drives the market cost down.

Also, the smaller the demand for a specific treatment, the higher the cost is of that medication. This is because pharmaceutical companies have to make more money per unit, as they will be selling the medication to fewer people.

Hepatitis C is a condition that affects approximately 3.5 million Americans, with as many as half potentially unaware that they have the infection, according to the United States Centers for Disease Control and Prevention (CDC).

The fact that hepatitis C is a condition that affects millions of people should mean the drugs cost less. Even so, current treatment regimens can be very costly.

Drug types and costs

In 2014, the United States Food and Drug Administration (FDA) approved drug treatments called direct-acting antiviral medications that were available in oral form only to treat hepatitis C, according to the journal Open Forum Infectious Diseases.

Several medications to treat hepatitis C have met FDA approval since then. Costs for hepatitis C treatment remain high, however.

The price of drugs may vary from between pharmacy, between insurance plans, and depending on a person's medical history. However, according to the University of Washington, the following are some average medication costs for hepatitis C treatments:

• Ledipasvir-sofosbuvir (Harvoni): The average wholesale cost for Harvoni is $1,125 per pill. An 8-week treatment course is $63,000 while a 12-week treatment course is $94,500 and a 24-week one is $189,000.
• Simeprevir (Olysio): The average wholesale cost for the medication is $790 per 150 milligrams (mg) capsule. A 28-day supply costs $22,120, and a 12-week supply costs $66,360. Sometimes a doctor will prescribe this along with the medication sofosbuvir, where a 12-week course of treatment for both medications totals about $150,000.
• Sofosbuvir (Sovaldi): This medication costs $1,000 per 400 mg pill. The total cost for a 12-week course is around $84,000, and doctors will typically prescribe it with other medicines, such as simeprevir.
• Ombitasvir-paritaprevir-ritonavir and dasabuvir (Viekira Pak): The cost for this medication is $83,319 for a 12-week treatment course. The cost for a 24-week treatment course is $166,638.

These costs are subject to change with market variables, the pharmacy a person is using, and the availability of the drug.

Tracking the costs of hepatitis C treatment

Researchers are continuing to create medications that shorten the duration of treatment for hepatitis C.

According to the Pharmacy Times, the cost of treatment can be as low as $54,600 for the 12-week course and the entry to the market of new, cheaper drugs is likely to continue to bring the cost of hepatitis C treatments down.

Will insurance cover treatments?

The level of insurance cover for hepatitis C treatments can vary, depending on a person's insurance policy and overall health.

Some insurance companies will pay for people whose hepatitis C has not responded to less-expensive treatments or for those who are already showing signs of liver damage.

Some insurance companies may require a person to prove they have been drug- and alcohol-free before authorizing treatment.

Insurance companies may believe people who fall into these categories will cost them less money.

If a person has a hepatitis C diagnosis, they may first ask what treatments their doctor recommends. Then, they should contact their insurance company to find out what medications their insurance plan may cover.

If you don't have insurance

Even if an insurance plan does not provide cover for treatments, there are still some patient assistance programs that help reduce the costs of specific treatments.

To find out about these, people can try researching the following:

• The Hepatitis C Mentor and Support Group, which maintains a listing of drug companies' patient assistance programs and advocacy groups.
• Individual drug companies, which may have information about their patient assistance plans.
• The website Support Path, which is from the manufacturer Gilead, the company that makes several hepatitis C treatment medications, including Epclusa and Sovaldi.
• Organizations that offer help to people with hepatitis C, including the American Liver Foundation, Hepatitis Foundation International, and NeedyMeds.

Obtaining additional financial assistance and discounts can sometimes be a time-consuming and frustrating process.

A person may wish to ask a doctor to recommend a social worker or financial assistance specialist in their office who can give advice on obtaining financial assistance.

Takeaway

Recent innovations in hepatitis C treatment mean that treatment is usually successful. However, for some people, the costs of these medications can be prohibitive.

While prices may decrease in the future, there are currently no guarantees. Seeking out rebate programs and financial assistance from specific organizations may help to make hepatitis C medications more affordable.

SOURCE: MEDICAL NEWS TODAY