Introduction and utilization of high priced HCV medicines across Europe : implications for the future

de Bruijn, Winnie and Ibáñez, Cristina and Frisk, Pia and Bak Pedersen, Hanne and Alkan, Ali and Vella Bonanno, Patricia and Brkičić, Ljiljana S. and Bucsics, Anna and Dedet, Guillaume and Eriksen, Jaran and Fadare, Joseph O. and Fürst, Jurij and Gallego, Gisselle and Godói, Isabella P. and Guerra Júnior, Augusto A. and Gürsöz, Hakkı and Jan, Saira and Jones, Jan and Joppi, Roberta and Kerman, Saim and Laius, Ott and Madzikwa, Newman and Magnússon, Einar and Maticic, Mojca and Markovic-Pekovic, Vanda and Massele, Amos and Ogunleye, Olayinka and O'Leary, Aisling and Piessnegger, Jutta and Sermet, Catherine and Simoens, Steven and Tiroyakgosi, Celda and Truter, Ilse and Thyberg, Magnus and Tomekova, Kristina and Wladysiuk, Magdalena and Vandoros, Sotiris and Vural, Elif H. and Zara, Corinne and Godman, Brian (2016) Introduction and utilization of high priced HCV medicines across Europe : implications for the future. Frontiers in Pharmacology, 7. 197. (https://doi.org/10.3389/fphar.2016.00197)

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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.

ORCID iDs

de Bruijn, Winnie, Ibáñez, Cristina, Frisk, Pia, Bak Pedersen, Hanne, Alkan, Ali, Vella Bonanno, Patricia ORCID logoORCID: https://orcid.org/0000-0002-6064-1323, Brkičić, Ljiljana S., Bucsics, Anna, Dedet, Guillaume, Eriksen, Jaran, Fadare, Joseph O., Fürst, Jurij, Gallego, Gisselle, Godói, Isabella P., Guerra Júnior, Augusto A., Gürsöz, Hakkı, Jan, Saira, Jones, Jan, Joppi, Roberta, Kerman, Saim, Laius, Ott, Madzikwa, Newman, Magnússon, Einar, Maticic, Mojca, Markovic-Pekovic, Vanda, Massele, Amos, Ogunleye, Olayinka, O'Leary, Aisling, Piessnegger, Jutta, Sermet, Catherine, Simoens, Steven, Tiroyakgosi, Celda, Truter, Ilse, Thyberg, Magnus, Tomekova, Kristina, Wladysiuk, Magdalena, Vandoros, Sotiris, Vural, Elif H., Zara, Corinne and Godman, Brian;
CORE (COnnecting REpositories)