Robert J. Fontana, M.D., and Anna S.F. Lok, M.D., have clinical and research interests in hepatitis C.
A national discussion
Cost shouldn’t be a barrier to a cure for hepatitis C
issue 22 | Fall 2014
The treatment of hepatitis C virus infection has reached a crucial juncture, because new screening guidelines and more effective medications have the potential to improve the health outcomes of hundreds of thousands of Americans. "Hep C is a leading cause of liver failure, liver cancer and liver transplant in the U.S. and Michigan," says Robert John Fontana, M.D., medical director of Liver Transplantation at UMHS. "Hep C is contagious before symptoms appear, so screening those at higher risk is essential to combating this disease."
However, controversy has surrounded hep C treatments because of the timing of two events. First, in 2012 the CDC issued recommendations to screen all Baby Boomers for hep C (see sidebar). A year after this recommendation, new, better tolerated and more effective hep C drugs debuted on market. However, these drugs are extremely expensive, a fact magnified by the large pool of potential patients.
"These events sparked a national discussion about the costs of treating hep C," says Fontana. "However, it's important to understand that these new drugs are far superior to previous medications, because they are less toxic, easier to use and are 90 percent effective in clearing the virus. For these reasons, we believe these medicines will allow primary care physicians to diagnose and treat patients with hep C, or easily triage patients to local specialists."
Fontana encourages advocacy to reduce the costs of these medications, as well as encouraging the discovery of more hep C drugs. He is joined in these efforts by Anna Suk-Fong Lok, M.D., director of Clinical Hepatology and associate chair for Clinical Research in the department of Internal Medicine.
"We should be communicating with insurance companies and government payers that these new drugs cure hep C, preventing progression to cirrhosis, liver failure and liver cancer, with enormous potential cost savings," says Lok. "Short-term, we also are asking drug companies to expand their assistance programs. However, long-term, we are advocating for more research and development of other hep C drugs to lower costs. We believe with pressure from patients and physicians, we can make a difference."