27 April 2016 - Expensive treatments for common conditions are unaffordable for most health system, even if they are cost effective.

The new direct acting antiviral drugs to treat hepatitis C infection are highly effective. Sofosbuvir and velpatasvir have been shown to achieve 90-100% cure rates regardless of hepatitis C virus (HCV) genotype. They are also very expensive, commanding list prices that can exceed US$1000 (£700; €880) a day. Nevertheless, studies have shown that treating everyone infected with HCV in the United States is cost effective from a societal perspective.

Moreover, manufacturers are already offering substantial discounts. Advocates are thus demanding that these drugs should be made available for everyone infected with HCV. The World Health Organization recently added sofosbuvir, along with other highly expensive medicines, to its model list of essential medicines.

However, HCV infection is so common that covering these drugs for all who might benefit is not a realistic option for most health systems, even if the price were $1 per pill, which is the estimated minimum cost of production, rather than $1000. So how should countries respond?

For more details, go to: http://www.bmj.com/content/353/bmj.i2035?etoc=