More than a decade after the first victories in the battle for
affordable HIV drugs, the gulf between the priorities of large
pharmaceutical companies and those of governments, affected communities
and the general public is again highlighted.
The new treatments for hepatitis C should herald a revolution; a
deadly disease can now be cured quickly and painlessly for a few hundred
dollars. But unless affordable treatments are made universally
available, millions of people in urgent need will be left behind.
Nobody who recognises the human cost of hepatitis C could question
the value of these new drugs. But even in wealthy countries such as
Australia, we are being forced to question their price tags.
Did you know that the HCV Advocate has a whole bunch of personal stories available for you to read to help you and your loved ones along the journey with hepatitis C. Read about how others have coped with their journeys, their struggles and their successes.
In the past, HCV genotype 3 was thought to be one of the easiest to cure. As a result there was little incentive to develop newer therapies especially since there were fewer people with genotype 3 in developed countries. Now it has turned out that treatment of genotype 3 is the hardest to cure with HCV inhibitor therapy compared to HCV genotypes 1, 2 and 4. HCV genotype 3 also contributes to the development of steatosis (fatty liver disease) and insulin resistance, both of which can directly influence HCV disease progression including cirrhosis and liver cancer.
The Centers for Disease Control (CDC) estimates that more than 3
million Americans have hepatitis C and many don’t know they have it.
Hepatitis C can remain hidden for decades before signs such as immune
dysfunction, jaundice and fatigue develop. If left untreated, it can
cause cirrhosis, or scarring of the liver, and eventually liver failure
Baby boomers have been designated as especially at risk. The CDC has
called for all people born between 1945 and 1965 to be tested for the
hepatitis C virus.
Finally, there are drugs to eradicate the hepatitis C virus that do
not require use of the dreaded drugs we have used for many years –
namely Interferon and/or Ribavirin.
For the first time, hepatitis C can be cured without interferon and ribavirin, which can cause fatigue and depression.
Finally, there’s a medication to cure hepatitis C that
doesn’t require use of the dreaded drugs interferon or ribavirin.
The U.S. Food and Drug Administration earlier
this month approved Harvoni, a once-daily tablet manufactured by Gilead
Sciences. Harvoni is a combination medication that includes sofosbuvir (Sovaldi),
another Gilead breakthrough treatment approved late last year, and ledipasvir,
which is also made by Gilead.
The new medication costs
$95,000 for a 12-week course of treatment. On the surface it appears even
more expensive than Sovaldi, which costs
$84,000 for a 12-week supply. Both medications have been proven to cure
hepatitis C in a majority of people with genotype 1 hepatitis C within that time
THE long-awaited new Hepatitis C drug will be available on Spain’s
national health system shortly, but only for certain patients.
to Dr María Londoño from the Hospital Clínic in Barcelona, a member of
the Spanish Agency for Medication and Healthcare Products, the drug
Sovaldi will be administered to sufferers awaiting a liver transplant or
who have undergone one, those with liver cirrhosis, or who have found
more traditional treatment to have been ineffective.
Those with minor fibrosis – which accounts for the majority of Hepatitis C sufferers – will not be given the new drug.
Hepatitis C has become an epidemic in Pakistan and there is no end in
sight since the governments neither have the will nor the wherewithal to
control this disease
The press is full of discussions about Ebola, dengue fever, polio and
whatever other disease catches the fancy of our media and our ‘ruling
class’ at any given time. I do not for a moment wish to denigrate the
efforts to control any disease especially the ones I mention above. But
there are other health problems that do not get adequate coverage. And
no, I am not referring to a simple matter like waterborne diseases that
could be controlled if clean water became available for people to drink.
Let me mention a particular condition that afflicts close to 12
million Pakistanis, more than 20000 new patients acquire this disease
every year; a number greater than in any other country in the world, and
more than 400 Pakistanis die from this disease every day. And in the
Punjab alone there are more than six million people infected with the
viruses causing this disease. What disease is this? Well dear readers if
you have not figured it out yet, it is what we call Hepatitis C.
(Statistics from Jang-Mera Shahr Lahore, October 28, 2014).
Statistics presented in a conference on Hep C held under the aegis of
the Punjab Department of Health and as reported in the news item
mentioned above suggest that the world over, on the average, one person
receives one or two injections every year. However, in Pakistan, the
average is between 13 and 14 injections every year and 70 percent of
these injections are given using unsterilized needles or syringes.
Dara Gantly on the pressure to provide full access to powerful new treatments.
It is not often we hear the word ‘cure’ mentioned in the development
of a new class of drug, but the direct-acting antiviral (DAAs) agents
for people with the hepatitis C virus (HCV) have that exact potential.
Indeed, this revolution in treatment could mean the ‘eradication’ for
the condition. The only barrier to achieving this will be the ability to
access and afford these new therapies. The ‘US$1,000 pill’ tagline has,
as you might expect, caused quite a stir among healthcare funders and
media alike, with some experts describing the costs of the drugs “as
breathtaking as their effectiveness”.
From the standard treatment for chronic HCV genotype 1 with
ribavirin, pegylated interferon and a protease inhibitor — which could
involve 18 tablets a day, last a year, have a limited response rate and
cause severe side-effects — patients with HCV are now being presented
with three months or less of oral medications that are offering a 90 to
95 per cent ‘cure’ rate, with experts talking about the eradication of
hepatitis C over the next decade.