OBJECTIVES: Chronic hepatitis C virus infection remains a significant public health problem with an estimated of 58 million people globally infected. Direct-Acting Antivirals (DAAs) have revolutionized Hepatitis C treatment and can achieve high cure rates (>90%). However, the costs of DAAs in Vietnam remain a potential barrier for treatment. Our study aims to investigate the costs of DAAs treatment for Hepatitis C in Vietnam in order to provide suggestions to increase the coverage of DAAs treatment.

METHODS: We performed a patient-level micro-costing analysis, including direct medical costs, direct non-medical costs and productivity costs. It based on a sample of 102 Hepatitis C outpatients recruited between 2020-2021 at the Hospital for Tropical Diseases in Ho Chi Minh City- which provides centralized Hepatitis C treatment for southern Vietnam

RESULTS: Depending on the specific drugs used, the average cost per standard 12-week DAAs treatment ranged between US$1305-US$1399 under the coverage of the national health insurance. The majority of these costs were related to the drugs. Even with the maximum coverage from the national health insurance scheme, the patients would still pay between US$486-US$533 in direct medical costs. This indicates that patients covered by health insurance incur considerable out-of-pocket costs. We also found that the patients that needed to travel from other provinces to Ho Chi Minh city for treatment presented the average of direct non-medical costs and productivity costs totalled from US$56 to US$76 per treatment, which up to three times higher than those living in the city just from US$27 to US$35.

CONCLUSIONS: Hepatitis C treatment remains expensive in Vietnam. Therefore, it is vital to come up with multiple approaches to reduce the costs. Our results also raise concerns regarding geographic inequity in the costs, where patients access to the treatment is highly varied. This further supports the need to decentralize Hepatitis C treatment.