AASLD: American Association for the Study of Liver Diseases

A late afternoon talk on the third day at The Liver Meeting 2014, evaluated the influence of some of the newer antiviral agents on "brain fog," a phenomenon quite commonly observed in hepatitis C virus-infected patients, especially among those with mild disease.

The efficacy of oral antivirals for hepatitis C infection is a moot point. The prevailing discussion now delves into the best combinations that can target different viral genotypes, access to these combination regimens, and the subsequent dent in the budget of the patient, the health plan, or the care provider-as the case may be.

Medicare costs, Department of Veterans Affairs budgetary costs, and the economic impact on the developing world-these were some of the topics discussed at the evening session, Health Economics and Cost-Effectiveness, on the third day at The Liver Meeting 2014, held in Boston, Massachusetts, November 7 to 11, 2014.

Amidst discussions on liver care, transplants, and infections was a session on Value-Based Medicine in Hepatology, on the third day at The Liver Meeting 2014, an annual event by the American Association for the Study of Liver Disease, held in Boston, Massachusetts, from November 7 to 11, 2014. Presenters saw a huge turnout for the session, a sign of increased interest in value-based care.

A pattern is emerging in the hepatitis C virus treatment realm-of the newly approved agents, the sofosbuvir- and simeprevir-based regimens are gaining traction. A poster session on approved therapeutic agents on November 9, 2014, at the annual meeting of the American Association for the Study of Liver Disease, proved this again.

Bashar A. Aqel, MD, Mayo Clinic, Phoenix, Arizona, presented results from phase 2 of the COSMOS (Combination Of SiMeprevir and sOfosbuvir in hepatitis C virus genotype 1 infected patients) trial.

While the cost of hepatitis C treatment continues to be a major topic of debate-with the approval of simeprevir (Olysio), sofosbuvir (Sovaldi), and now the combination, sofosbuvir and ledipasvir (Harvoni)-those in favor of the treatment provide a strong research-based argument. The cost-debate is global, as shown by this cost-effectiveness study conducted in Italy.

While the cost of novel hepatitis C drugs has been rigorously debated, real-world data on the safety and efficacy of these drugs has now started showing up. A white paper released by CVS Health Research Institute in September of this year reported that in addition to the downward trend in utilization of sofosbuvir, which has cure rates of more than 95%, high discontinuation rates are being observed.

According to the CDC, hepatitis C virus infection is a common chronic disease that currently affects about 3.2 million people in the United States, and although less common it remains a significant health problem in children, according to the American Liver Foundation.