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    More Now Die in U.S. From Hepatitis C Than HIV

    Many, Especially Baby Boomers, Don’t Even Know They’re Infected

    Deciding Who Should Get the New Medications

    In a related study, Stanford University researchers examined the cost-effectiveness of treatment with the least-expensive protease inhibitor along with the conventional drugs pegylated interferon and ribavirin.

    Using a mathematical model, they also looked at whether testing hepatitis C patients for a gene linked to a satisfactory response to conventional treatment might be helpful in deciding who should also get a protease inhibitor.

    One of the new protease inhibitors, Victrelis, costs $1,100 per week, while the other, Incivek, costs $4,100 a week, the authors write. Each must be taken for months.

    “In addition to the high cost, these drugs also have substantial side effect risks,” says researcher Jeremy Goldhaber-Fiebert, PhD, an assistant professor of medicine at the Stanford University School of Medicine. “Even for patients whom the drugs effectively cure, there is a real chance of feeling absolutely miserable during weeks of treatment.”

    Goldhaber-Fiebert and his co-authors conclude that this triple therapy is cost-effective in all hepatitis C patients with advanced liver fibrosis, or scarring caused by inflammation, which can lead to cirrhosis.

    He says a protease inhibitor might not be cost-effective as part of initial therapy in patients with mild liver fibrosis who have the genetic predisposition that responds well to the conventional treatment with pegylated interferon and ribavirin.

    Ward and Goldhaber-Fiebert published their findings in the Annals of Internal Medicine.

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