Using Gilead Sciences’ Harvoni (ledipasvir/sofosbuvir) to treat hepatitis C virus (HCV) when individuals with genotype 1 of the virus have milder cases of liver fibrosis is more cost effective than waiting until their liver disease progresses. Researchers came to this conclusion by devising a mathematical model to help them estimate how earlier versus delayed treatment, specifically among those never before treated for the virus, affected the proportional cost associated with improving their life span as well as individual health.

This finding faces some difficult realities. As the study’s head, Harinder S. Chahal, PharmD, MSc, a pharmacologist at the University of California, San Francisco, notes, “For many hepatitis C patients, the current price of the drug as set by Gilead is limiting access to the cure, and this needs to be addressed.”

“Due to the high cost, insurers and clinicians have no choice but to resort to rationing of care for the sickest patients first,” Chalal says. “This is a direct outcome of the high sale price of the drug.”