Journal of Hepatology, August 2015
Revolutionary new drugs to cure hepatitis C virus (HCV) infection represent one of the most important breakthroughs in clinical medicine in recent decades. However, high pricing of these well-tolerated, highly efficacious all-oral regimens and high demand (actual or anticipated) has led many payers in the United States and other countries to exclude people who have recently used illicit drugs, injectable drugs or alcohol (with the definitions of “use” varying by jurisdiction) from access to these treatments. The intention of this article is to consider the ethical and evidentiary basis of the restrictions that have been instituted to date. We will examine restrictions to assess whether they meet evidenced-based medical and public health criteria, and whether they satisfy the principle of justice.