Dr. Gonzalez on Cost-Benefit of Treating Hepatitis C in HCC Patients Before Transplant

Stevan A. Gonzalez, MD MS, clinical assistant professor, department of internal medicine, Texas A&M College of Medicine, medical director of liver transplantation, Simmons Transplant Institute, Baylor All Saints Medical Center, discusses a cost effectiveness analysis of treating hepatitis C patients with hepatocellular carcinoma (HCC) before or after a liver transplant.

Gonzalez and his team developed a model to determine if it was cost-effective to treat U.S. hepatitis C with all oral direct acting antivirals for HCC patients on the waiting list for liver transplant. The goal was to determine if was more cost-effective to treat pre-transplant or post-transplant. Data related to transition to progression of HCC and progression of disease and the efficacy of antiviral therapy were used for the analysis.

The study found that it was cost-effective to treat pre-transplant. Treating before transplant also decreased liver-related mortality and increased sustained virologic response, says Gonzalez. Pre-treatment did not have any impact at time of the liver transplant waitlist.