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APPENdIX A. PEER REVIEw COMMENTS/AUThOR 

RESPONSES

comment response

The data is intriguing but in my view still somewhat We appreciate the assessment. We hope to repeat 

preliminary. I would like to see this repeated in a this analysis and plan to do so should funding 

year or two to see if the patterns observed hold up permit.

Results of this report may influence decisions about Again, we appreciate this assessment and hope 

future formulary status of boceprevir and telaprevir. to be as relevant to VA decision makers.

Results have the potential to indirectly influence 

future decision making about formulary status of 

HCV medications as more DAA drugs are developed 

and come available. The VA also must review 

policy for future HCV antibody testing guidelines. 

These results are highly relevant to such guideline 

decisions.

No specific recommendations. It is appropriately Thank you.

structured as-is, given available data resources, to 

best inform decisions at hand.

p.18: This is a strong summary of the available We agree that this could be a possibility and that 

data as they exist in the literature and in VA data better data would help. We have noted this when 

resources. On p18, the authors discuss the sources we described this number stating “, though this 

used in concluding the estimates of number of may be somewhat lower in the VA population if 

veterans with HCV infection who are treatment the studies were conducted in populations who 

eligible, and who take up treatment if eligible. As are more likely to be eligible for treatment.” 

is pointed out, best estimates of these numbers (Page 18)

vary quite a bit, and the conclusion arrived at here 

is that 45% of those in care are treatment eligible. 

I suspect that this figure may be a bit high, as it is 

derived quite substantially from samples selected 

for greater intensivity of treatment than is likely the 

national norm. However, pending better empiric data 

I suspect it is not too much of an overestimate and is 

reasonable.

There are studies on the way genetic test can change We have noted that this possibility exists but 

behavior. In this case it is possible that knowledge of have not modeled this as there are no data on 

IL28B status might encourage compliance. how IL28B changes behavior (and none specific 

to the VA) that we know of. We have noted this 

in the limitations: “Furthermore, there are other 

patient, provider, and facility characteristics that 

may play a role in determining use of these new 

technologies and additionally, depending on the 

results from IL-28B testing may also play a role 

in determining subsequent clinical actions and 

patient behaviors. Information in this area could 

help to further refine the analyses presented 

here.”
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Assessment of Alternative Treatment Strategies 

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a table outlining the breakdown of component costs. of the current study. 
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