OBJECTIVES : Hepatitis C virus (HCV) infection is a major cause of chronic liver disease, with approximately 71 million chronically infected individuals worldwide. However, highly efficacious interferon-free treatments based on direct acting antivirals (DAA) are now available. Currently in Poland public payer (NFZ) therapeutic program for HCV treatment management reimburses DAA therapies. The aim of this study was to evaluate the number of available DAA treatments reimbursed by NFZ and to estimate the budgetary impact of reimbursement between 2016-2018.

METHODS : To estimate number of available DAA therapies as well as to calculate the expenditure of NFZ for reimbursed treatment between 2016 -2018 we used a real cost data in the form of the quantity of medicines sold by the pharmacies and the total amount of refunds for individual medicine.

RESULTS : In 2016 only sofosbuvir (SOF) was approved for reimbursement in Poland. The NFZ expenditure for reimbursement of SOF was around 10,8 mln EUR. During the next two years elbasvir/grazoprevir as well as glecaprevir/pibrentasvir were included in the reimbursement list and the annual reimbursement cost increased to 21,9 mln EUR. In 2018 NFZ provided reimbursed of 4 different treatment including SOF, sofosbuvir/velpatasvir, elbasvir/grazoprevir, glecaprevir/pibrentasvir. The comparison of countries with close GDP per capita showed that only in Croatia, Greece and Portugal more DAA drugs one or two were respectively reimbursed in 2017. According to the available data the annual reimbursement cost of DAA in Poland was over 24,4 mln EUR in 2018.

CONCLUSIONS : A reimbursed IFN-free therapeutic program is already available in Poland. Every year more new therapeutic options became available to help the medical practitioner in selecting an appropriate and safe regimen. The NFZ expenditure for reimbursement of DAA treatment increased each year, and as a results more patients can get access to highly effective treatment.