The rationing of new treatments for hepatitis C, a devastating yet curable infection, is unprecedented. This presentation will discuss how prices are set for drugs in general with analogies to other high-priced specialty medications in order to understand how prices of direct-acting antiviral (DAA) regimens for hepatitis C treatment may have been determined. Cost-effectiveness studies for hepatitis C (screening and treatment) will be reviewed with a summary of which populations appear cost-effective to treat relative to no treatment and older regimen choices. In general, treatment of hepatitis C is as cost-effective as the treatment of many other diseases in the United States. The role of payers in determining the actual price paid for drugs as well as access to treatment will be discussed. Cost-effectiveness does not equal affordability and the cost of hepatitis C regimens in the short term does pose budget challenges to systems that did not adequately prepare for the demand. Stigma associated with hepatitis C impacts the current reimbursement climate, and physicians and other health providers will need to be advocates for individual patients and on a broader policy level in order to fulfill the promise of these transformative new treatments.
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