Innovative use of antiviral therapy for Hepatitis C and drug policy initiatives made news this week in the ongoing fight against what has been called a silent killer. Quicker treatment times and lower costs means that the next generation of antiviral treatments for Hepatitis C will reach – and cure – more and more of the millions of people worldwide who suffer from the debilitating liver disease.
A study funded by the European Association for the Study of the Liver (EASL) found that Hepatitis C could be effectively cured in just six weeks using a combination antiviral drug therapy. The study was conducted on patients with acute HCV – the virus that causes Hepatitis C. Antiviral therapy consisting of sofosbuvir and ledipasvir together resulted in a 95 percent cure rate against Hepatitis C. The test subjects were still cleared of Hepatitis C a full 12 weeks after antiviral therapy. The researchers at Hannover Medical School in Germany concluded that the combination antiviral therapy was not only effective in curing Hepatitis C, but the drastic shortening of the usual treatment period did not appear to have any effect on whether or not the treatment worked.
The length of treatment is a huge issue because of the high costs involved in antiviral therapy for Hepatitis C. Professor Frank Tacke, EASL Governing Board member, is quoted in Science Daily.
“These exciting findings open up short and cost-effective treatment options that could prevent the spread of HCV in high risk populations.”
Up till about three years ago, treatment for Hepatitis C generally consisted of a year-long regimen of frequent injections and daily pills with flu-like side effects. Since the introduction of sofosbuvir and similar Hepatitis C antiviral medications in 2013, a typical course of treatment generally lasts three to six months, and a full cure is possible.
However, there are key issues that have prevented the next generation of antiviral therapies from reaching many of the world’s Hepatitis C sufferers. The cost of antiviral drugs that target Hepatitis C has always been problematic, particularly given the fact that it is most prevalent in countries of middle to low socioeconomic status. Sovaldi, the brand name of sofosbuvir, became the most profitable drug launch in history when it debuted on the market in 2014 at a whopping $1,000 per tablet. The antiviral drug’s market price in the United States is over $80,000 for a 12-week treatment.
Even in developed countries, the cost of Hepatitis C antiviral therapy means that many in the United States simply can’t afford the treatment. In Canada, with a socialized medical environment, the drug is carefully rationed out only to select patients, according to a CBC report.
Hepatitis C: Treatment Under $300 to Be Available Within 18 to 24 Months, Researchers Say— Afshine Emrani M.D. (@afshineemrani) April 17, 2016
Researchers from the... https://t.co/gLDi8ctCbg
At the International Liver Congress in Barcelona, Spain this past week, an announcement by the Drugs for Neglected Diseases Initiative, an international non-profit organization, and Egyptian drug maker Pharco Pharmaceuticals takes a big step towards addressing the antiviral cost issue. Pharco has agreed to supply sofosbuvir and ledipasvir, another Hepatitis C antiviral drug, for less than $300 USD per treatment course for a pilot project in Malaysia and Thailand.
While the price only currently applies to the specific agreement that was announced, a representative of Doctors Without Borders, a member of the Drugs for Neglected Diseases Initiative, told the CBC there are hopes that the organization will be able to renegotiate the price of the antiviral drug combination for Hepatitis C — currently at about $80,000 USD per course of therapy — for other countries too, including wealthy nations like Canada and the United States.
Hepatitis C is often called a “silent killer.” HCV, the virus that causes Hepatitis C, clears by itself in 10 to 50 percent of people who become infected, but it is rare to have an early diagnosis — before HCV has become full blown Hepatitis C. By the time symptoms appear, liver damage has already occurred.
About 130 to 150 million people across the globe currently have Hepatitis C, and it causes about half a million deaths every year. According to the Pakistani Tribune, about 5 percent of the population in Pakistan is currently affected by Hepatitis C, or about 10 million people. Hepatitis C and its complications account for about 30 percent of all Pakistani hospital admissions. There are 6 million cases of Hepatitis C in Egypt. According to a piece in the Baltimore Sun, there are over 3 million people in the United States with Hepatitis C. That figure may jump soon as more and more middle-aged Americans get tested for Hepatitis C in the wake of new medical guidelines.
Symptoms of Hepatitis C infection are progressive and can include internal bleeding, swelling due to accumulation of fluid in the abdomen, jaundice, coma and complete liver failure. As a viral condition, Hepatitis C can be spread by contact with contaminated blood, such as by sexual contact or by reusing needles, a common practice in many parts of the world as well as among recreational drug users.
The newest generation of antiviral therapies mean there is real hope that Hepatitis C can be eliminated entirely from wealthy regions of the world like North America. Shorter courses of treatment and cheaper drugs extend the hope for a cure to Hepatitis C sufferers worldwide.
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