In two decades, HCV treatment

was transformed from a “one size fits all” approach to a complex, individualized therapy that is tailored to optimize outcomes for specific subsets of patients and responses. HCV therapy comes at a cost. The total medication cost of Bortezomib cost current protease inhibitor-based therapy generally ranges from $52,600 to $89,700 depending on agents used and duration of therapy required. However, the true cost of HCV care goes far beyond pricing of drugs. It is the opportunity cost of care that threatens widespread availability of treatment. Extensive evaluation and monitoring that is required for standard of care (SOC) HCV therapy threatens to become impossibly time-consuming for many providers to continue treating HCV patients. For example, SOC

therapy for a genotype 1 treatment-naïve patient may require 6 to 8 clinic visits and 50 to 66 separate laboratory tests that must be drawn and interpreted. Patent education, laboratory monitoring, and clinic visits are more extensive with current therapy, and are often under-reimbursed and poorly incentivized in many healthcare systems. HCV treatment currently requires more expertise than ever to deliver safe and effective care. In evidence, DAA-based triple therapy requires more comprehensive understanding of potential drug-drug interactions, learn more viral kinetics, risk factors for generating viral resistance, and side effect management of patients who are vulnerable to rash, anemia, and decompensated liver disease. These factors threaten to alienate many providers and may shrink an already limited workforce equipped to deliver HCV care. Age-based screening of U.S. patients born between 1945 and 1965 has recently been recommended by the Centers for Disease Control and Prevention (CDC) to better identify up to 800,000 previously undiagnosed and untreated individuals. In our current system, complexity of care has created an imbalance of increasing efficacy with diminishing access to HCV therapy. The next generations of DAAs have the potential to significantly reduce the

burden of on-treatment evaluation and monitoring; however, it will be crucial that a primary focus in development is to cure disease on a population scale rather than an individualized approach. Advances in treatment, especially in a global epidemic, are only useful if they have practical, medchemexpress useful, and widespread applications. The HCV pipeline of new therapeutic agents is robust and moving forward at high speed. New antiviral agents such as newer NS3/4A protease inhibitors, NS4B inhibitors, NS5A inhibitors, NS5B polymerase inhibitors, lambda interferons, and cyclophilin inhibitors are currently under development and hold promise for safer, simpler, and more effective therapy. However, as long as HCV therapy remains complex, SVR rates that approach 100% are less impressive unless a plan is in place that allows for widespread use.