Copyright by Jocelin R. Teachout 2017



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Copyright © by Jocelin R. Teachout

2017





Mackey R. Friedman, Ph.D., MPH


ABSTRACT

Hepatitis C infection is a chronic, debilitating disease with complications such as liver cancer and liver cirrhosis. In the United States, hepatitis C infection can be cured only with direct acting antiviral treatment. However, the cost of hepatitis C antiviral treatment is expensive, hindering many Americans from receiving treatment. Insurance companies and pharmaceutical companies control access to hepatitis C antiviral treatment as out-of-pocket costs are unaffordable for most individuals. A literature review was conducted to investigate strategies to reduce the high cost of hepatitis C antiviral treatment using PubMed database. The research question of “What are current or future strategies that could reduce the high cost of hepatitis C antiviral treatment in the US market to increase access?” focused this literature review’s purpose. Relevant studies were those published from 2013 to present that included strategies to decrease the cost of hepatitis C antiviral treatment. Articles were excluded if they included a genotype other than genotype 1, represented studies conducted in a country other than the United States, or a specific clustering of individuals in the title such as injection drug users, at-risk populations, and prison inmates. Thirty-one studies met the criteria for inclusion in this literature review. Fifteen articles indicated increased market competition (48.3% of the total included articles) as a strategy to decrease the cost of hepatitis C antiviral treatment. Modifications to the pharmaceutical industry were emphasized in 12 articles (38.7% of the total included articles) such as promoting competition, research of equivalent drugs, and partnerships with other pharmaceutical companies as a means of decreasing hepatitis C antiviral treatment costs. Eleven articles suggested that stakeholder involvement (35.5% of the total included articles) could help to reduce hepatitis C antiviral treatment costs. Eight studies suggested that business/finance industry modifications (25.8% of the total included articles) could lower hepatitis C antiviral treatment costs. These studies assist in developing strategies to reduce the high financial burden on people living with hepatitis C and furthering public health significance in reducing hepatitis C transmission.




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