Background: Direct-acting antiviral agents (DAAs) have revolutionised treatment for the hepatitis C virus (HCV). Currently, treatment costs between 20,000 and 80,000 Australian dollars ($A) per patient. The Australian Federal Government provided $A1 billion over 5 years to subsidise these drugs.

Objective: The aim of this paper was to evaluate the uptake and financial impact of DAA prescribing in Australia.

Methods: We undertook a retrospective analysis of Medicare prescription and expenditure data for March 2016 to August 2017. Prescription numbers and expenditure data were extracted from the Medicare Statistical Reports website. Numbers of prescriptions were converted to per capita rates. HCV prevalence measures were used to provide context to prescription rates. All costs were reported in $A, year 2017 values.

Results: Nationally, 211,184 DAA prescriptions were reimbursed. Whilst $A3.6 billion was expended through the Pharmaceutical Benefits Scheme, confidential pricing agreements precluded calculation of the precise cost. In 18 months, estimated expenditure greatly exceeded the $A1 billion in funding for 5 years. Nationally, the rate of prescriptions was 872/100,000 individuals. Prescription rates were highest in the Australian Capital Territory (1087/100,000) and lowest in Western Australia (625/100,000) despite HCV prevalence being comparable to the national rate in both regions.

Conclusions: Uptake of DAAs has been enthusiastic in the first 18 months of this funding agreement. However, the lack of transparency due to the confidential special pricing agreements means actual government expenditure is unknown. Post-marketing review by the Pharmaceutical Benefits Advisory Committee may enable renegotiation of DAA prices with the sponsors.

Item Type:	Refereed Article
Keywords:	hepatitis C, expenditure, DAAs, transparency, Australia
Research Division:	Economics
Research Group:	Applied Economics
Research Field:	Health Economics
Objective Division:	Health
Objective Group:	Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:	Infectious Diseases
UTAS Author:	de Graaff, B (Ms Barbara de Graaff)
UTAS Author:	Yee, KC (Dr Kwang Yee)
UTAS Author:	Palmer, A (Professor Andrew Palmer)
ID Code:	125536
Year Published:	2018
Web of Science® Times Cited:	2
Deposited By:	Menzies Institute for Medical Research
Deposited On:	2018-04-22
Last Modified:	2018-12-11
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