Introduction and Utilization of High Priced HCV Medicines across Europe; Implications for the Future.

Isabella Piassi Dias Godói ,Newman Madzikwa,Anna Bucsics,Celda Tiroyakgosi,Roberta Joppi,Mojca Matičič ,Hanne Bak Pedersen,Janelle Jones ,Jurij Fürst,Elif Hilal Vural ,Hakkı Gürsöz,Joseph Fadare ,Ljiljana Sović Brkičić ,Pia Frisk,Ott Laius,Kristina Tomekova,Brian Godman,Steven Simoens,Einar Magnússon,Ali Alkan,M Wladysiuk ,Winnie De Bruijn,Ilse Truter,Saim Kerman,Guillaume Dedet,Jutta Piessnegger,Vanda Marković-Peković ,Augusto Afonso Guerra Júnior ,Magnus Thyberg,Sotiris Vandoros,Jaran Eriksen,Corinne Zara,Saira Jan,Gisselle Gallego,Patricia Vella Bonanno,Amos Massele,Aisling O’leary ,Cristina Ibáñez,Catherine Sermet,Olayinka O Ogunleye

doi:10.3389/fphar.2016.00197

Abstract

Background: Infection with the Hepatitis C Virus (HCV) is a widespread transmittable disease with a diagnosed prevalence of 2.0%. Fortunately, it is now curable in most patients. Sales of medicines to treat HCV infection grew 2.7% per year between 2004 and 2011, enhanced by the launch of the protease inhibitors (PIs) boceprevir (BCV) and telaprevir (TVR) in addition to ribavirin and pegylated interferon (pegIFN). Costs will continue to rise with new treatments including sofosbuvir, which now include interferon free regimens.Objective: Assess the uptake of BCV and TVR across Europe from a health authority perspective to offer future guidance on dealing with new high cost medicines.Methods: Cross-sectional descriptive study of medicines to treat HCV (pegIFN, ribavirin, BCV and TVR) among European countries from 2008 to 2013. Utilization measured in defined daily doses (DDDs)/1000 patients/quarter (DIQs) and expenditure in Euros/DDD. Health authority activities to influence treatments categorized using the 4E methodology (Education, Engineering, Economics and Enforcement).Results: Similar uptake of BCV and TVR among European countries and regions, ranging from 0.5 DIQ in Denmark, Netherlands and Slovenia to 1.5 DIQ in Tayside and Catalonia in 2013. However, different utilization of the new PIs vs. ribavirin indicates differences in dual vs. triple therapy, which is down to factors including physician preference and genotypes. Reimbursed prices for BCV and TVR were comparable across countries.Conclusion: There was reasonable consistency in the utilization of BCV and TVR among European countries in comparison with other high priced medicines. This may reflect the social demand to limit the transmission of HCV. However, the situation is changing with new curative medicines for HCV genotype 1 (GT1) with potentially an appreciable budget impact. These concerns have resulted in different prices across countries, with their impact on budgets and patient outcomes monitored in the future to provide additional guidance.

Highlights

Introduction and Utilization of High Pricedhepatitis C virus (HCV) Medicines across Europe; Implications for the FutureEdited by: Dominique J
This article was submitted to Pharmaceutical Medicine
it is believed that the diagnosed global prevalence of HCV is

Summary

Introduction

Introduction and Utilization of High PricedHCV Medicines across Europe; Implications for the FutureEdited by: Dominique J. Pedersen H, Alkan A, Vella Bonanno P, Brkicic LS, Bucsics A, Dedet G, Eriksen J, Fadare JO, Fürst J, Gallego G, Godói IP, Guerra Júnior AA, Gürsöz H, Jan S, Jones J, Joppi R, Kerman S, Laius O, Madzikwa N, Magnússon E, Maticic M, Markovic-Pekovic V, Massele A, Ogunleye O, O’Leary A, Piessnegger J, Sermet C, Simoens S, Tiroyakgosi C, Truter I, Thyberg M, Tomekova K, Wladysiuk M, Vandoros S, Vural EH, Zara C and Godman B (2016) Introduction and Utilization of High Priced HCV Medicines across Europe; Implications for the Future. Infection with the Hepatitis C Virus (HCV) is a widespread transmittable disease with a diagnosed prevalence of 2.0%.

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