skip to Main Content

New Analysis Finds Cost-Effectiveness Models for Hepatitis C Drugs Often Overlook Market-Based Prices

  • This page as PDF


In recent years, several new U.S. Food and Drug Administration-approved, direct-acting antiviral medications to treat the chronic hepatitis C virus (HCV) have entered the market. Because of the potential impact on health plan and pharmacy budgets, researchers have conducted economic analyses, including cost-effectiveness analyses, to understand the value of the new medications.
Please note: This is an archived post. Some of the information and data discussed in this article may be out of date. It is preserved here for historical reference but should not be used as the basis for business decisions. Please see our main Insights section for more recent posts.

Experts at Avalere reviewed available health economics literature, from the payer perspective, to determine if cost-effectiveness models assessing new direct-acting antivirals used market-based pricing rather than medication list pricing, which does not factor in discounts. While the models revealed that the drugs generally were cost effective, many models that Avalere analyzed used list pricing instead of using market-based pricing that reflects the net cost to plans as suggested by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines. Using list pricing as a benchmark may not reflect the actual price paid by the customer, which could potentially lead to miscalculating the cost-effectiveness of the treatment and an undervaluation of the medication being assessed.

The Avalere analysis concludes that as various assessment organizations and researchers determine the clinical and economic value of new and innovative therapies, it is important that they use sound methodologies to provide payers, consumers, and others with accurate information regarding the costs and cost effectiveness of the new drugs.

Read the full report here.

For more information, please contact Caroline Pearson at

Webinar: Decoding the CY 2025 Advance Notice Join Avalere’s healthcare policy experts as they dissect the CY 2025 Medicare Advantage Advance Notice and discuss the future trajectory of MA in Part D and potential outcomes, headwinds, and tailwinds for health plans. Learn More
Watch the Recording

Sign up to receive more insights about
Please enter your email address to be notified when new insights are published.

Back To Top