According to the American Liver Foundation, 4 million Americans, or 1.8% of the population, are or have been infected with the hepatitis C virus. Approximately 70% of infected persons will develop a chronic infection that may progress to liver cirrhosis, hepatocellular carcinoma or even end-stage liver disease requiring transplantation. The United Network for Organ Sharing (UNOS) reports that healthcare costs during the year surrounding liver transplantation surgery can exceed $500,000. And while emerging therapies for the treatment of hepatitis C demonstrate superior sustained virologic response (SVR) rates compared with current therapies, our survey data suggest plans remain skeptical about the economic and clinical benefits of emerging therapies. Using tiering and restrictions data from Fingertip Formulary, as well as insight from 50 pharmacy directors, this report determines the key trends in reimbursement of therapies for hepatitis C, drivers of these trends, and how stakeholders can capitalize on future shifts in coverage to steal share from the competition.


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