OBJECTIVES: Taiwan Ministry of Health and Welfare decided to extend coverage for oral hepatitis C drugs to all the patients. It is expected to eradicate the disease by 2025. The objective of this study was to assess the budget impact of introducing direct-acting antivirals (DAAs) coverage for all HCV patients from the perspective of the Taiwan health care payer.

METHODS: A budget impact model was developed with a five-year time horizon (2019-2023) to estimate the long-term budget impact on the National Health Insurance after introducing DAA-based treatments (Glecaprevir/pibrentasvir ) for all genotypes of patients with chronic HCV infection in Taiwan. We compared the new scenario with the historical situation based on the traditional therapy available prior to 2018. The eligible patient population was derived from the local published epidemiology data. Drug unit costs were obtained from the National Health Insurance Administration. The exchange rate of all costs was converted by 30 New Taiwan dollars per US dollar. RESULTS: The introduced new coverage policy The annual drug cost of DAA-based therapy was 26.6 million US dollar and pegylated interferon /ribavirin was 9.9 million US dollar, respectively. Due to the high cure rate of the innovative new drug, this decreases the eligible patients for the treatment year by year. In 2019-2023, the health insurance fund for the hepatitis C treatment would be decreased by 15.45, 15.56, 15.63, 15.68, 15.72 million US dollar, respectively.

CONCLUSIONS: Compared with pegylated interferon /ribavirin, the novel direct-acting antivirals (DAAs) is a relatively cheaper alternative with comparable clinical efficacy for HCV patients in Taiwan.