Economic sustainability of therapies: considerations following the introduction of new drugs for hepatitis C virus

The availability of new drugs potentially able to drastically reduce the burden of very common infectious diseases like hepatitis C requires the national health services to take a different decision-making process. On the one hand, there is an evident financial issue; on the other hand, low budgets may undermine a system that provides universal access to healthcare. It is unrealistic to expect retrieving the financial resources needed from negotiating prices with pharmaceutical companies, resource reallocation or a reduction in economic waste. The national health systems need a new priority setting and a National fund for healthcare innovation should be built. Novel drugs should be evaluated balancing availability and opportunity, forcing to rethink the decision-making processes. Macro- (re-prioritization of interventions) and micro-policies (the introduction of financial aspects in the process of pricing) are needed, trying to combine welfare and industrial policies.