The Annals of Internal Medicine published an interesting article last March investigating the cost effectiveness of new HCV antiviral therapies. The authors concluded that, assuming a cutoff cost of $100,000 per quality-adjusted life-year, sofosbuvir containing regimens are cost effective for most genotypes. With that said, treatment of all eligible HCV sufferers would result in overwhelming financial burden to the American healthcare system – estimated at $27 billion per year or 10% of prescription drug spending. Therefore, without a massive increase in funding to government and private insurers, rationing of these therapies is currently necessary. This article poses interesting questions regarding cost conscious care, drug expense and the allocation of scarce resources in a time of exponentially growing healthcare expenditure. It’s certainly worth a look.