Frontiers in Pharmacology (Jul 2016)

Introduction and utilisation of high priced HCV medicines across Europe; implications for the future

  • Winnie de Bruijn,
  • Cristina Ibáñez,
  • Pia Frisk,
  • Hanne Bak Pedersen,
  • Ali Alkan,
  • Patricia Vella Bonanno,
  • Ljiljana Sović Brkičić,
  • Anna Bucsics,
  • Guillame Dedet,
  • Jaran Eriksen,
  • Joseph O Fadare,
  • Jurij Fürst,
  • Gisselle Gallego,
  • Isabella Piassi Godói,
  • Isabella Piassi Godói,
  • Augusto Afonso Guerra Junior,
  • Augusto Afonso Guerra Junior,
  • Hakki Gürsöz,
  • Saira Jan,
  • Saira Jan,
  • Jan Jones,
  • Saim Kerman,
  • Roberta Joppi,
  • Ott Laius,
  • Newman Madzikwa,
  • Einar Magnusson,
  • Mojca Maticic,
  • Vanda Markovic-Pekovic,
  • Vanda Markovic-Pekovic,
  • Amos Massele,
  • Olayinka Ogunleye,
  • Olayinka Ogunleye,
  • Aisling O’Leary,
  • Jutta Piessnegger,
  • Catherine Sermet,
  • Steven Simoens,
  • Celda Tiroyakgosi,
  • Ilse Truter,
  • Magnus Thyberg,
  • Kristina Tomekova,
  • Magdalene Wladysiuk,
  • Sortiris Vandoros,
  • Elif Hilal Vural,
  • Corinne Zara,
  • Brian Godman,
  • Brian Godman

DOI
https://doi.org/10.3389/fphar.2016.00197
Journal volume & issue
Vol. 7

Abstract

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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. Utilisation measured in defined daily doses (DDDs)/ 1000 patients/ quarter (DIQs) and expenditure in Euros/ DDD. Health authority activities to influence treatments categorised 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 utilisation of the new PIs versus ribavirin indicates differences in dual versus 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 utilisation 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 negotiations across countries, with their impact monitored in the future to provide additional guidance.

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