Discoveries Magazine


From the Dean of Faculty


The Cost of Curing Chronic Diseases — and the Benefits That Make It Worthwhile

Curing the incurable is the physician-scientist’s dream. That aspiration recently became a reality in the case of hepatitis C, a viral disease whose sufferers faced a bleak set of treatment options until just a few years ago. News of the remarkable advance was heralded among healthcare providers and patients but also generated understandable payer controversy — the cost of the cure was estimated at $84,000 per patient.

That expense is unquestionably high and likely reflects both significant development costs and complex market forces, but the existence of a cure provides priceless hope for patients and their loved ones. Hepatitis C is a chronic infection that affects roughly 150 million people worldwide and annually is responsible for 20,000 deaths in the United States alone. Clinical trials of the new treatment demonstrated cure rates of more than 90 percent. Not only does the pill eliminate the need for physically, emotionally, and financially burdensome liver transplants but it also costs far less: Estimated billed charges for a liver transplant can total more than $577,000, not including the considerable expense of critical immunosuppressive drugs and medical follow-ups.

Today, researchers at Cedars-Sinai and around the world have set their sights on another liver-related public health crisis: nonalcoholic fatty liver disease, which affects a growing number of Americans and can develop into often-fatal cirrhosis. An article in this issue of Discoveries chronicles the cutting-edge work of experts in our Fatty Liver Disease Program as they seek new approaches to diagnosis, clinical care, and prevention of this disorder.

Their work is increasingly urgent because the need for liver transplants — the ultimate outcome of severe fatty liver disease — far exceeds the supply of appropriate donor organs. In this issue, an article on transplantation notes that the number of livers donated each year barely makes a dent in our patients’ overall need. This disparity will only grow, with nonalcoholic fatty liver disease expected to supplant hepatitis C as the leading indication for liver transplants by 2020.

At Cedars-Sinai, our scientists and clinicians make it a priority to engage with one another to translate discoveries into health-saving therapies. If we and our peers have the ingenuity to achieve a future in which transplants are no longer required, we may replicate our success with hepatitis C in other currently incurable diseases. As a community, we realistically can aspire to cure most liver disease and leave an enduring, economically responsible health delivery legacy for our children and grandchildren.

Shlomo Melmed, MD
Executive Vice President, Academic Affairs
Dean of the Medical Faculty
Helene A. and Philip E. Hixon Distinguished Chair in Investigative Medicine

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