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    FAQ: The High Cost of Hepatitis C Drugs

    Q: Is Sovaldi less expensive outside the U.S.?

    Yes, Rest says. In lower-income countries, the company has put ''tiered pricing'' into place, based on the country's gross national income and the number of hepatitis C cases.

    Q: What about all the savings in terms of fewer people infected and fewer treatments for chronic infection complications?

    From a public health standpoint, reducing the number of infected people is desirable, Masur says. "The more sick people in the population, the higher the hazard to public health," Masur says, since an infected person can spread the virus.

    The higher cure rate with the newer oral drugs offers multiple benefits, Carey says. "It runs the gamut, from saving people from the emotional turmoil of hepatitis C to reducing the likelihood of developing cirrhosis, dying of liver failure, or getting liver cancer.''

    But, he says, the time it would take for the treatment costs to be offset by the savings in other treatments will probably be lengthy. In one scenario evaluated by the nonprofit Institute for Clinical & Economic Review, analysts say only two-thirds of initial drug costs would be offset by medical savings at the 20-year mark.

    Q: What's the future likely to hold, and will prices decline?

    Several other hepatitis C drugs are under study, and competition may solve the cost problem, or least improve it. ''To some extent this is probably going to be a self-correcting problem," Carey says. ''Although Gilead and Johnson & Johnson have the corner on the market now, there are plenty of other drugs in development." As those drugs become approved, supply and demand will drive down the costs of the two current drugs.

    One oral drug under development, known as ABT-450, cured more than 95% of patients, even in some who weren't helped by other treatments. The study results were presented at the annual meeting of the European Association for the Study of the Liver in London Thursday and published in the New England Journal of Medicine online. The study was funded by AbbVie, the maker of the new drug.

    Also this weekend, scientists reported positive results using Sovaldi in combination with another Gilead drug, ledipasvir. Those results were published in the April 12 issue of the New England Journal of Medicine.

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