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The US Food and Drug Administration approved the first daily oral antiviral for the treatment of hepatitis C virus (HCV) infection in November 2013. This and subsequent antivirals represented a marked improvement compared with the prior regimen of ribavirin and injectable interferon. However, the extraordinary costs of the medications have resulted in controversy as to which patients can and should be offered therapy. Many have argued that only those with advanced fibrosis or cirrhosis should be offered treatment because of the cost of the medications and the fact that most people with HCV do not experience progression to serious disease. In this issue of JAMA Internal Medicine, Chahal and colleagues1 present a decision-analytic model that predicts treatment of HCV infection at early stages of fibrosis to be cost-effective.
Yee HF. Treatment of Hepatitis C Virus Infection in Real Life. JAMA Intern Med. 2016;176(1):73-74. doi:10.1001/jamainternmed.2015.6659