– The cost of hepatitis C treatment varies according on the type of medicine used. However, the price range for an 8- to 12-week course is $54,000 to $95,000 (or higher). A 12-week prescription of Zepatier, for instance, can cost up to $54,600, while a 12-week course of Harvoni can cost up to $94,500.
Can primary care manage Hepatitis C?
Direct-Acting Antiviral Agents for Hepatitis C Treatment—Patients Without Cirrhosis – ” description=” Based on information acquired at http://www.goodrx.com, this is the estimated retail price for a complete treatment course (accessed June 12, 2018).
†— See eTable B for information regarding pharmaceutical assistance programs for uninsured and underinsured patients. Information extracted from source 11. “SVR can repair liver fibrosis, and when viral hepatitis is healed, even cirrhosis can begin to reverse.12 SVR attained with direct-acting antivirals is not known to minimize the incidence of hepatocellular carcinoma, however new research is hopeful.13 , 14 SVR patients had a decreased incidence of diabetes mellitus, glomerulonephritis, non-Hodgkin lymphoma, stroke, and other diseases, which reflects the systemic character of chronic hepatitis C.15 It is unclear if the high cost of direct-acting antivirals is covered by long-term benefits from lower morbidity and death associated with hepatitis C.
Economic estimates vary by health care system and research type (e.g., whether the study end point is focused on achieving SVR or on post-SVR improvements in HCV-related extrahepatic disease).16 – 19 A normal treatment course is one to three tablets per day for eight to 12 weeks, and is typically well tolerated.
At four weeks, viral counts are acquired to evaluate efficacy. A last test is conducted at least 12 weeks after the last tablet has been consumed. Patients with pretreatment signs of cirrhosis are recommended to have lifetime monitoring for hepatocellular carcinoma utilizing liver imaging and -fetoprotein tests at six-month intervals.20 Prior HCV infection and treatment do not give immunity; thus, patients at high risk of reinfection (e.g., those with active injection or intranasal drug use, sex partners of infected individuals) should undergo periodic screening.21 Family physicians are encouraged to treat hepatitis C by the Centers for Disease Control and Prevention.22 When prescribing direct-acting antivirals to patients with uncomplicated hepatitis C, primary care doctors achieve equivalent outcomes to subspecialists.23 Patients with hepatitis C who do not have cirrhosis or who have compensated cirrhosis react favorably to primary care physician therapy.
Patients with decompensated cirrhosis (marked by ascites, esophageal varices, or hepatic encephalopathy) require sophisticated treatment. Family doctors should be able to detect and refer these individuals to a gastroenterologist or hepatologist. Family physicians who want to treat patients with hepatitis C have access to training and assistance.
- A sensible first step would be to finish one or more online courses at your own leisure (eTable A).
- Because some insurers need contact with a subspecialist prior to covering direct-acting antivirals, telemedicine programs like Project ECHO (Extension for Community Healthcare Outcomes) might be useful.
These services give cheap, real-time access to subspecialist consulting in the form of case presentations. aafp-journal-article-table-and-figure enlarge-url= “/pubs/afp/issues/2018/1001/p413/jcr:content/root/aafp-article-primary-content-container/aafp article main par/aafp tables content0.enlarge.html ” print-url=”/pubs/afp/issues/2018/1001/p413/jcr:content/root/aafp-article-primary-content-container/aafp article main par/aafp tables content0.print.html ” id=”afp20181001p413-ta” text=”eTABLE A” number-text=”” heading=”