HEPATITIS C PLAN COST AND TREND CALCULATOR
FOR EMPLOYERS AND HEALTH PLAN SPONSORS

Learn more about this tool on Lab.Express-Scripts.com. Download the instructions here
ENTER YOUR INFORMATION IN THIS BLUE AREA ONLY.
NUMBER OF MEMBERS
PERCENTAGE OF
MEMBERS/BENEFICIARIES
BY PLAN TYPE:
Commercial %
Medicare %
Dual Eligible Medicare/Medicaid %
Medicaid %
 
MUST TOTAL 100% %
  REGIMEN MIX:      
  2014   2015 2016
GENOTYPE 1: % % %
 
Triple Therapy (12 weeks) % % %
Sovaldi® + Ribavirin (24 weeks) % % %
Sovaldi® + Olysio (12 weeks) % % %
New Therapies % % %
 
NON-GENOTYPE 1: % % %
ESTIMATED PERCENTAGE OF CHRONIC HEPATITIS C PATIENTS TO BE TREATED EACH YEAR:
2014 %
2015 %
2016 %
 
Your 2013 Per Member Per Year (PMPY) Cost:
 
 
 
Calculations and Estimates
HEPATITIS C PATIENT POPULATION TREATMENT AND COST ESTIMATES
ESTIMATED NUMBER OF PATIENTS
BY PLAN TYPE:
Commercial
Medicare
Dual Eligible Medicare/Medicaid
Medicaid
TOTAL
TOTAL PATIENTS STRATIFIED
BY DISEASE SEVERITY:
Category 1
(Non-Cirrhotic Liver Disease)
Category 2
(Compensated Cirrhosis)
Category 3
(End-Stage Liver Disease)
TOTAL
Year 1       Year 2       Year 3      
ESTIMATED TREATMENT COSTS:                  
ESTIMATED NUMBER OF PATIENTS TREATED BY CATEGORY:
(Prioritizing by Disease Severity)
Treat Category 3 Only
Treat Category 2 & 3 Only
Treat All Patients
ESTIMATED PLAN COSTS:       3-Year Totals
Treat Category 3 Only
Treat Category 2 & 3 Only
Treat All Patients
ESTIMATED PMPY COSTS (WITH YEAR-OVER-YEAR CHANGE)
TREAT ALL PATIENTS TREAT CATEGORY 2 & 3 ONLY TREAT CATEGORY 3 ONLY
 
Baseline PMPY Cost   
 
Forecast PMPY Cost   
 
Year-Over-Year Change
Create a report to help with your pharmacy benefit planning and share a copy with your account representative.
Talk with an account representative about hepatitis C savings opportunities.  
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