OBJECTIVES: Treatment of chronic hepatitis C is changing fast given the amount of new drugs coming to the market. Little is known about the budget impact and long term implications of the different treatment options. The objective of this study was to estimate the budget impact of different treatment options on national or regional level and to evaluate the short-term as well as long-term implications of different hepatitis C treatments. METHODS: A model flexible for regional and national Swedish cohorts of hepatitis C patients was developed. Cost and effect inputs were taken from published sources and clinical trial data. Using the model, total budget impact as well as cost per cured patient was estimated for different treatments. In addition, long term consequences of different treatments were estimated using a Markov model with transition probabilities from the published model in the field by Lidgren et al.(1) RESULTS: Given efficacy rates of over 95%, the new treatments of hepatitis C will cure more patients in Swedish cohorts compared to previous treatments with efficacy rates of around 65%. In the long term, the superior effectiveness of the new treatments would translate into decreases in cases of decompensated cirrhosis, hepatocellular cancer and liver transplants of over 90% among these patients. CONCLUSIONS: The new treatments of hepatitis C could improve virologic outcomes among patients. In the long term, cost-savings from reduced burden of disease among these patients are also to be expected. However, in the short term these treatments will require twice the budget size compared to earlier antiviral therapies in this field. (1.) Lidgren M, Hollander A, Weiland O, Jonsson B. Productivity improvements in hepatitis C treatment: impact on efficacy, cost, cost-effectiveness and quality of life. Scand J Gastroenterol. 2007 Jul;42(7):876-77