Analysis and Suggestions on the Situation of Hepatitis C Treatment and Related Medical Insurance Compensation Mechanism in China / 中国药房

ABSTRACT

OBJECTIVE:To provide reference and suggestion for relieving the disease burden of hepatitis C (HC) in China,improving medical compensation mechanism of HC treatment and the accessibility of HC drags.METHODS:By reviewing literatures and other relevant information,the epidemic situation of HC,the situation of disease screening and diagnosis,treatment progress,the economic burden of disease,medical insurance compensation in China and international experience on improving the accessibility of HC drugs were all analyzed.RESULTS:The anti-HCV prevalence rate of 1 to 59-year-old population was 0.43％ in China,and the genotype was mainly genotype 1b(58％).Nearly 38.9％ of the patients were not treated.For patients with genotype 1b,the sustained virologic response rate of traditional PEG-interferon combined with ribavirin regimen was 62％,and the effect of new direct-acting antivimls (DAA) regimen was improved significantly;patients receiving new regimen could gain 1.29 QALYs and 0.85 life years.The costs of a single course for traditional and new regimens were 54 960 yuan and 57 810 yuan,respectively.New regimen could save 378 yuan for the cost of disease management for each patient due to evasion of end-stage liver disease.After medical insurance compensation,the cost of self payment had fallen sharply for workers and residents receiving traditional regimen,while new regimen was approved in China in 2017 and had not been covered by medical insurance yet.CONCLUSIONS:New regimen has a cost-effectiveness advantage over traditional regimen.The state should pay more attention to HC patients and take measures to reduce the economic burden of them.By improving the basic medical insurance and special medical assistance fund for HC treatment,the accessibility of the drugs in new HC treatment regimen can be improved.