Broad hepatitis C treatment scenarios return substantial health gains, but capacity is a concern

Treatment of hepatitis C virus, the most common chronic viral infection in the United States, has historically suffered from challenges including serious side effects, low efficacy, and ongoing transmission and reinfection. Recent innovations have produced breakthrough therapies that are effective in more than 90 percent of patients. These treatments could dramatically reduce the virus's prevalence but are costly. To quantify the benefit of these treatments to society, including the value of reduced transmission, we estimated the effects of several hepatitis C treatment strategies on cost and population health. Treating patients at all disease stages could generate $610-$1,221 billion in additional qualityadjusted life-years, plus an additional $139 billion in saved medical expenditures over fifty years, and minimize the disease burden, but upfront treatment costs would exceed $150 billion. An intermediate scenario-treating 5 percent of the infected population annually, regardless of patients' disease stages-would also return substantial benefits and would be much more affordable under current financing schemes.