Ethical assessment of hepatitis C virus treatment: The lesson from first generation protease inhibitors

Lucia Craxi', Calogero Camma', Pietro Refolo, Roberta Minacori, Antonio Gasbarrini, Antonio G. Spagnolo, Americo Cicchetti, Dario Sacchini

Risultato della ricerca: Articlepeer review

6 Citazioni (Scopus)

Abstract

Since chronic hepatitis C has mostly become curable, issues concerning choice and allocation of treatment are of major concern. We assessed the foremost ethical issues in hepatitis C virus therapy with 1st generation protease inhibitors using the personalist ethical framework within the health technology assessment methodology. Our aim was to identify values at stake/in conflict and to support both the physicians' choices in hepatitis C therapy and social (macro-) allocation decision-making.The ethical assessment indicates that: (1) safety/effectiveness profile of treatment is guaranteed if its use is restricted to the patients subgroups who may benefit from it; (2) patients should be carefully informed, particularly on treatment deferral, and widespread information on these therapies should be implemented; (3) since treatment was proven to be cost-effective, its use is acceptable respecting resource macro-allocation. Concerning individual (micro-) location criteria: (a) criteria for eligibility to treatment should be clearly identified and updated periodically; (b) information on criteria for eligibility/deferral to treatment for specific patients' subgroups should be made widely known.Interferon-based regimens will disappear from use within the next year, with the introduction of highly effective/tolerable combination regimens of direct-acting antivirals, thus profoundly changing social choices. Nonetheless, our model could support future ethical assessment since the evaluation pertaining ethical domains remains generally applicable.
Lingua originaleEnglish
pagine (da-a)351-355
Numero di pagine5
RivistaDigestive and Liver Disease
Volume47
Stato di pubblicazionePublished - 2015

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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