A recent economic analysis led by CBPartners in collaboration with Inova Fairfax and Gilead Sciences has demonstrated that utilising new direct-acting antiviral therapies in hepatitis C, which are safer and more effective than older pegylated interferon- and ribavirin-containing therapies, can lead to significant cost savings in the United States and five European countries (EU5) due to improved worker productivity. To determine this, the total economic impact of chronic hepatitis C in terms of lost productivity was first monetised, and then compared to the projected productivity when utilising newer therapies, which have demonstrated marked improvements on work productivity-related patient-reported outcomes. Incorporating these improvements even only during a one-year period was projected to result in cost savings of $2.7bn and €435mn in the USA and EU5 alone, respectively – significant cost-offsets when considering payers’ concerns over the high price of these new therapies.
These data demonstrate the importance of considering the broader societal economic impact from adoption of high-cost yet more efficacious agents. Traditional economic analyses focus only on direct medical cost-offsets due to improved efficacy and / or safety; however, this approach does not appropriately capture the wider societal impact of therapies in terms of cost-savings on an employer and national level. Currently, few HTA bodies explicitly and consistently incorporate the societal perspective in their assessments. Only Sweden and the Netherlands formally consider a societal perspective when evaluating new technologies, considering lost productivity, work loss, and time loss for patients.
While these data may not make a significant impact on the decision whether or not to reimburse new technologies, there are other significant upsides to undertaking cost analyses from a societal perspective. Although not formally assessed, emphasising the economic benefits on a per employed patient basis due to improved work productivity may resonate positively with employer groups that purchase commercial insurance plans in the USA. In addition, given the raucous debate lately regarding the high cost of these hepatitis C therapies, it is important to highlight data supporting that these drugs result in substantial economic gains both from offset long-term costs as well as short-term gains in productivity. Ultimately, capturing all economic gains obtained through treatment can positively influence wider perception of high-cost agents, reorienting the conversation to what is gained through treatment rather than simply focusing on the cost of these therapies themselves.