Amsterdam 2015
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| Abstract #2166 - Costing the epidemic | ||||
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Session: 9.5: Costing the epidemic (Symposium) on Wednesday @ 11.30-13.00 in 202 Chaired by Anne Cockroft, Alexander Pastoors Authors: Presenting Author: Ms Adeline Toullier - AIDES, France |
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| Additional Authors: | ||||
| Aim: The fight against Hepatitis C has undergone a revolution since the development of new direct-acting antiretroviral drugs (DAAs) which offer the possibility of effectively taking action against this epidemic. In November 2014, after negotiations with Gilead laboratory, who markets SOVALDI, the leading DAA, the Economics Committee for Health Products set the price at 41,000 euros for a three-month course, whereas production costs are estimated at 101 dollars. Selection criteria for patients to receive this medication free of charge are strictly medical as defined by order of the Ministry of Health. Thus, individuals who are HIV/HCV co-infected should be treated whatever the stage of fibrosis. | ||||
| Method / Issue: Several charities and patient organisations testify to delays and hindrances in access to care among the HCV infected individuals catered for by their organisations. At the same time, changes in recommendations in terms of treatment required are analysed. | ||||
| Results / Comments: The first expert report on « Case management for people infected with Hepatitis B or C in France » published in May 2014, provides precise guidelines on treatment indications which were restricted last June by the French Health Authority. These restrictions mean less people are concerned by the initial guidelines and therefore the efficacy of the fight against this epidemic is reduced. These restrictions also justify limiting required treatment. Health-care teams are influenced by the price of SOVALDI leading them to choose some patients over others, to delays in providing treatment, even to refuse to treat some patients although they fulfil the requirements for access to treatment. | ||||
| Discussion: Budget cuts encountered by health services and economic restrictions could lead to a policy of rationing treatment or sorting patients according to criteria which fuel negative social representation of the most vulnerable populations: the price could be used as a reason to refuse treatment to marginalised people and those living in unstable conditions thus compounding pre-existing social inequalities in health. For some, this could cause lower life expectancy, complications and illness-related disabilities and even lead patients to use less expensive, less effective treatment. This situation does not bode well for access to new treatment and extends well beyond hepatitis infections, and should be the subject of further studies. | ||||
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