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Publication type: Article in scientific journal
Type of review: Peer review (publication)
Title: Drug pricing evolution in Hepatitis C
Authors: Vernaz, Nathalie
Girardin, François
Goossens, Nicolas
Brügger, Urs
Riguzzi, Marco
Perrier, Arnaud
Negro, Francesco
DOI: 10.21256/zhaw-4045
Published in: PLOS ONE
Volume(Issue): 2016
Issue: 6
Pages: 1
Pages to: 12
Issue Date: 2016
Publisher / Ed. Institution: Public Library of Science
ISSN: 1932-6203
Language: English
Subjects: Antiviral agent; Cost-benefit analysis; Drug discovery; Drug therapy; Genotype; Hepacivirus; Hepatitis C; Human; Interferon; Oligopeptide; Ribavirin; Ritonavir; Sofosbuvir; Switzerland; United States; Drug pricing
Subject (DDC): 338: Production
615: Pharmacology and therapeutics
Abstract: Objective: We aimed to determine the association between the stepwise increase in the sustained viral response (SVR) and Swiss and United States (US) market prices of drug regimens for treatment-naive, genotype 1 chronic hepatitis C virus (HCV) infection in the last 25 years. We identified the following five steps in the development of HCV treatment regimens: 1) interferon (IFN)-α monotherapy in the early '90s, 2) IFN-α in combination with ribavirin (RBV), 3) pegylated (peg) IFN-α in combination with RBV, 4) the first direct acting antivirals (DAAs) (telaprevir and boceprevir) in combination with pegIFN- α and RBV, and 5) newer DAA-based regimens, such as sofosbuvir (which is or is not combined with ledipasvir) and fixed-dose combination of ritonavir-boosted paritaprevir and ombitasvir in combination with dasabuvir. Design: We performed a linear regression and mean cost analysis to test for an association between SVRs and HCV regimen prices. We conducted a sensitivity analysis using US prices at the time of US drug licensing. We selected randomized clinical trials of drugs approved for use in Switzerland from 1997 to July 2015 including treatment-naïve patients with HCV genotype 1 infection. Results: We identified a statistically significant positive relationship between the proportion of patients achieving SVRs and the costs of HCV regimens in Switzerland (with a bivariate ordinary least square regression yielding an R2 measure of 0.96) and the US (R2 = 0.95). The incremental cost per additional percentage of SVR was 597.14 USD in Switzerland and 1,063.81 USD in the US. Conclusion: The pricing of drugs for HCV regimens follows a value-based model, which has a stable ratio of costs per achieved SVR over 25 years. Health care systems are struggling with the high resource use of these new agents despite their obvious long-term advantages for the overall health of the population. Therefore, the pharmaceutical industry, health care payers and other stakeholders are challenged with finding new drug pricing schemes to treat the entire population infected with HCV.
Fulltext version: Published version
License (according to publishing contract): CC BY 4.0: Attribution 4.0 International
Departement: School of Management and Law
Appears in collections:Publikationen School of Management and Law

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