Sovaldi (sofosbuvir) is a cost-effective treatment option for hepatitis C virus (HCV) among the prison population when compared with other options, SFGate reports. This finding is complicated, however, by the fact that to treat inmates, prison health care systems must bear all of the upfront costs without necessarily reaping any of the savings yielded down the line.

Publishing their findings in the Annals of Internal Medicine, researchers devised a hypothetical prison population and used computer modeling to determine the performance and cost of treating HCV-positive inmates in two scenarios: treating with 28 weeks of Victrelis (boceprevir) plus interferon and ribavirin; or treating with 12 weeks of Sovaldi (sofosbuvir) plus interferon and ribavirin. The model took into account variations in the length of inmates’ sentences and liver health as well as the increased prevalence of the virus in prison populations.

Treating with Sovaldi yielded an additional 2.1 quality-adjusted life years (QALYs) with an additional cost of $54,000 when compared with not treating. Victrelis added just 1.3 additional QALYs.

“It looks like the additional benefits of [Sovaldi] are sufficiently large even in this high-risk population to justify its increased cost,” Jeremy Goldhaber-Fiebert, PhD, an assistant professor of medicine at the Stanford School of Medicine and senior author of the study, said in a release.

Sovaldi’s relative cost-effectiveness is likely little consolation to those overseeing prison health care budgets. The assessment takes into account costs to society in general, including Medicaid, and over a span of many years. A prison would have to pay the full amount of treatment up front and would not eventually save money on treated individuals who were released from the correctional system.

The study does not take into account the recent approval of Gilead Sciences’ Harvoni (ledipasvir/sofosbuvir), which is priced similarly to the total cost of treating with Sovaldi, interferon and ribavirin and which offers higher cure rates. Because many people with hep C may be able to take Harvoni for just eight weeks instead of 12, the price would actually come down for treating those individuals when compared with the 12-week Sovaldi treatment cost.

To read the press release, click here.

To read the study abstract, click here.

To read the SFGate story, click here.