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Lowering the High Cost of Hepatitis C Drugs

Audrey R Chapman and Thomas Buckley

Escalating prices for prescription drugs have contributed to the rise in health care costs in the United States and made many medicines increasingly unaffordable. This situation is particularly problematic for essential but very expensive drugs needed by large numbers of people. This article focuses on one of these, the unsustainable cost of hepatitis C medications. Hepatitis C is estimated to affect some 3 million, mostly poor, Americans and more than 185 million people globally. Chronic hepatitis C infection can progress to liver cirrhosis, cancer, and liver failure. Several recently developed direct-action antiviral medications offer highly effective treatment with few adverse effects, but their use is limited by their very high cost. List prices in the United States for the most used hepatitis C drugs are upwards of $84,000 per patient for the standard 12 week treatment course. This article discusses factors accounting for the high cost of these drugs and the public health implications of the resulting restrictions in access. It then considers potential policy mechanisms to reduce the cost showing that the major limitation has not been the absence of policy levers to lower the cost but the reluctance of the federal government to utilize them. The article concludes by identifying the factors deterring the government from doing so.