OBJECTIVES Hepatitis C represents a great challenge for public health. Incidence rate in Brazil in 2017 was 11.9 cases/100 thousand inhabitants, but many ignore their seropositive status. Treatment can reduce risk of hepatocarcinoma and cirrhosis, main complications of disease, to 75%. In the last decade, the Brazilian Ministry of Health (MoH) has invested in the incorporation of several drugs for the treatment of Hepatitis C in the public health system (SUS), including Direct Acting Antiretrovirals (DAA), a new class recognized as having the highest efficacy in controlling the disease. This study examined purchases of DAAV by the MoH from 2015 to 2018, to profile volumes, expenditures and prices.

METHODS Data from the federal government purchasing system (SIASG) were collected for current DAAs available in SUS: sofosbuvir; simeprevir; daclatasvir; ritonavir+ombitasvir+veruprevir+dasabuvir; ledipasvir+sofosbuvir; elbasvir+grazoprevir; glecaprevir+pibrentasvir, and velpatasvir+sofosbuvir. Number of purchases, volumes, unit prices, yearly expenditures and type of purchase were analysed. The weighted average annual price (WAAP) for each drug was calculated. Prices were adjusted by the National Consumer Price Index (IPCA) to December/2018

RESULTS 63 DAAs purchases were observed, the first in 2015, when availability of DAAs and inclusion in Hepatitis C clinical guidelines (PCDT) began. During the period 19,951,932 dosage forms were purchased, corresponding to R$ 2.551.556.008,21 in total expenditures. Sofosbuvir and daclastavir totaled 73% of acquired volumes and 88.4% of expenditures. Small volumes of simeprevir were bought in 2015 e 2016, and the manufacturing industry reported the definitive discontinuation of the product in Brazil in April 2018. The association ritonavir+ombitasvir+veruprevir+dasabuvir incorporated in 2016 totaled over 4.22 million dosage forms and 21.1% of expenditures. All medicines had a drastic decrease in price after incorporation.

CONCLUSIONS Brazil has been actively incorporating new DAAs for Hepatitis C in SUS, and the related expenditures are steep, even though there are no purchases of new drugs included in 2018.