Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
School of Medicine, University of Tasmania, Hobart, Australia.
Appl Health Econ Health Policy. 2018 Aug;16(4):495-502. doi: 10.1007/s40258-018-0392-8.
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.
The aim of this paper was to evaluate the uptake and financial impact of DAA prescribing in Australia.
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.
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.
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.
直接作用抗病毒药物（DAAs）彻底改变了丙型肝炎病毒（HCV）的治疗方法。目前，每位患者的治疗费用在 20000 至 80000 澳元（A）之间。澳大利亚联邦政府在 5 年内提供了 10 亿澳元用于补贴这些药物。
本文旨在评估澳大利亚 DAA 处方的采用情况和对财务的影响。
我们对 2016 年 3 月至 2017 年 8 月期间的医疗保险处方和支出数据进行了回顾性分析。从 Medicare 统计报告网站提取了处方数量和支出数据。将处方数量转换为人均比率。HCV 流行率数据用于为处方率提供背景。所有成本均以澳元报告，为 2017 年的价值。
在全国范围内，有 211184 份 DAA 处方获得了报销。尽管通过药品福利计划支出了 36 亿澳元，但由于保密定价协议，无法计算确切的成本。在 18 个月内，预计支出大大超过了 5 年 10 亿澳元的资金。全国范围内，处方率为 872/10 万个人。处方率在澳大利亚首都领地最高（1087/10 万），在西澳大利亚州最低（625/10 万），尽管这两个地区的 HCV 流行率与全国水平相当。
在这项资金协议的头 18 个月里，DAA 的采用率很高。然而，由于保密的特殊定价协议，缺乏透明度意味着实际政府支出尚不清楚。药品福利咨询委员会的上市后审查可能使赞助商重新谈判 DAA 的价格。
