AUTHOR=de Bruijn Winnie , Ibáñez Cristina , Frisk Pia , Bak Pedersen Hanne , Alkan Ali , Vella Bonanno Patricia , 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 , Godman Brian 

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

JOURNAL=Frontiers in Pharmacology

VOLUME=7

YEAR=2016

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2016.00197

DOI=10.3389/fphar.2016.00197

ISSN=1663-9812

ABSTRACT=<p><bold>Background:</bold> 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.</p><p><bold>Objective:</bold> 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.</p><p><bold>Methods:</bold> 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).</p><p><bold>Results:</bold> 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.</p><p><bold>Conclusion:</bold> 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.</p>