An Estimate of the Cost of Hepatitis C Treatment for the Brazilian Health System

ObjectivesHepatitis C therapy in Brazil is expensive due to the cost of antiviral drugs and demands on medical resources. The objective of this study was to estimate the direct costs per patient of chronic hepatitis C therapy in a Brazilian setting.MethodA microcosting study from a public health system perspective. The costs included were those of antiviral drugs, secondary medicines, diagnostic tests, visits to physicians and other professionals, hospitalization, nurse, and pharmaceutical care. All costs were priced in 2010. The values were converted to US $ (2010).ResultsThe total direct cost of hepatitis C treatment per patient with interferon alpha (IFN) plus ribavirin (RBV) was US $982.25, with peginterferon alpha (PEG) 2a 180 μg plus RBV was US $10,658.08, and with PEG 2b 120 μg plus RBV was US $12,597.63, taking into account entire treatment according to Brazilian guidelines and assuming that all patients completed full treatment. The antiviral drugs are the most expensive element of the cost of treatment, totaling more than 40% of the medical costs of IFN plus RBV therapy and more than 88% of PEG plus RBV therapy. Calculating an average of 10,000 treatments per year, the total direct cost is US $90,346,772.39. According to the Ministry of Health, 90% of the annual total cost of hepatitis C treatment is accounted for by antiviral drugs.ConclusionsIn Brazil, antiviral drugs are the most expensive component of hepatitis C treatment. The cost of follow-up and support to patients is minimal compared with the cost of antiviral drugs.