Advocates Scandalized That Gilead’s Hepatitis C Profit Have Raked in US$25.8 Billion, Which Could Have Treated Everyone While Still Earning Us$16 Billion in Profits – From Treatment Action Group
People living with hepatitis C, access to medicines activists, and the medical community around the world “mark” the fifth birthday of the first all-oral, one dose per day cure sofosbuvir (Sovaldi®), launched by Gilead Sciences. A global hepatitis C coalition has released a fact sheet revealing treatment barriers that resulted in only 1.85 million of the 71 million people worldwide who need treatment, receiving Gilead’s sofosbuvir-based drugs, largely due to pricing, patents and registration delays.
Since 2013, Gilead reaped US$58.6 billion in hepatitis C product sales, of which 25.8 billion are estimated profit1, with a fraction of these earnings invested in research and development. Instead, in 2017 alone, Gilead spent US$14.8 billion rewarding shareholders. This amount is more than sufficient to treat everyone with chronic hepatitis C with generic versions.
Title: #202 HCV-RNA Is Readily Detectable in Nasal and Rectal Fluids of Patients with High Viremia – David Chromy, et al. By Lucinda Porter, RN
The purpose of this research was to better understand the mechanisms of HCV transmission among men who have sex with men (MSM). This prospective study enrolled 34 subjects with acute or chronic HCV infection. Researchers analyzed HCV RNA (viral load) obtained from rectal and nasal swabs from all participants. Fecal occult blood tests were performed to rule out rectal bleeding. Participants completed questionnaires to assess risk behavior related to recreational drug use and sexual practices.
Here are the results: The mean age of participants was 43 years; all but one were HIV-positive; 82% were male of whom 64% were MSM. Acute HCV was observed in 32% (11/34) with all subjects being HIV+MSM. Twenty-three (68%) patients had at least one positive swab sample (56% nasal and 52% rectal), whereas blood contamination was never detected. Individuals with positive swab samples had significantly higher HCV-RNA levels vs. those with negative swab samples.
Conclusion: Despite the absence of blood, HCV-RNA is readily detectable in rectal and nasal fluids in patients with acute and/or chronic hepatitis C. This suggests that unprotected anal intercourse and sharing of drugs via nasal route may be high-risk practices for HCV transmission, especially in patients with high HCV viral levels.
Editorial Comments: First, this is a small study. Second, we need more studies like this. Third, this research has the potential to shed light on transmission routes for which we need more information.
Title: Abstract: #88 Prevalence of Chronic Hepatitis C Virus Infection, US States and District of Columbia, 2013-2016 – Eli Rosenberg, et al. By Lucinda Porter, RN
The increase in injection drug use among younger people is driving an increase in the number of hepatitis C virus (HCV) infections. To prevent and treat hepatitis C, epidemiologists need to know where the highest prevalence exists in the United States. This study updated existing surveillance methods to obtain an accurate assessment.
These researchers estimated that during 2013-2016, nearly one percent of adults (2.5 million persons) in the United States had hepatitis C. Half of these infections were in nine states: Alaska, Arizona, Kentucky, Louisiana, New Mexico, Oklahoma, Oregon, Tennessee, West Virginia plus Washington, D.C.
Conclusion: These prevalence estimates support evidence-based evaluation and planning for HCV prevention, treatment, and ultimately elimination.
Editorial Comments: These high prevalence regions mirror many of the areas where there is a huge opioid problem. If effective measures are not put in place, hepatitis C transmission and reinfection rates will continue to climb. So will opioid-related injuries and deaths.
MSF, along with Médecins du Monde (MdM), AIDES (France), Access to Medicines Ireland, Praksis (Greece) and Salud por Derecho (Spain), filed an appeal requesting that the EPO revoke Gilead’s patent. They argue it lacks the patentability requirement “from a legal or scientific perspective,” according to an MSF press release. The filed appeal document was not available at press time.
Successful treatment of recently acquired hepatitis C virus (HCV) genotype 1 infection in 8 weeks, with a regimen currently approved for 12 weeks, adds to growing evidence that early detection could enable shorter, less costly treatment and more rapid reduction of the infectious viral pool.
Marianne Martinello, MBBS, PhD, of the Viral Hepatitis Clinical Research Program, Kirby Institute, University of New South Wales, Australia, and colleagues contributed a new study to the list of trials involving shortened durations of direct-acting antiviral (DAA) regimens for acute and recent HCV infections.
Their new findings suggest early detection is key to more patients being eligible for these increasing, and increasingly efficient treatment options.
Though cardiovascular disease, diabetes, Alzheimer’s, and others have remained among the greater drivers of mortality, other conditions have spread like wildfire in just less than 3 decades. Among them, opioid use disorder (OUD) mortality has raised by 447.3%, and liver disease due to hepatitis C by 75.4%.
With the rise of these conditions also came the fall of previously-feared epidemics: HIV/AIDS, a public health crisis and the 13th-leading cause of death in 1990, killed fewer Americans in 2016 than 50 other conditions. Access to highly-efficacious antiretroviral therapy (ART), pre-exposure prophylaxis (PrEP), and a growing understanding of how and when to test at-risk patient populations have made HIV a good example of clinical response to a growing disease.
Bold move from leadership will reduce deaths from hepatitis C in Oregon
OREGON CITY, OR, November 30, 2018 – Caring Ambassadors Program applauds the bold leadership shown by Governor Brown and the Oregon Health Authority (OHA) this week. On Wednesday, the Governor introduced her budget which includes funding for hepatitis C treatment and a forward-looking statement that brings our state into alignment with the World Health Organization’s goal of hepatitis C elimination by 2030.
From Governor Brown’s budget “• Ending Hepatitis C – New treatments exist to cure individuals living with Hepatitis C. An investment in the 2017-19 biennium enabled OHA to expand treatment to Oregon Health Plan patients with later stages of the disease. The Governor’s Budget increases this investment with an additional $10 million General Fund to ensure treatment is available to Oregon Health Plan members with any stage of the disease and puts the state on track to eradicate the cascading effects of Hepatitis C infections.” [2019-2021 Governor’s Budget, State of Oregon]
The second bold move critical to hepatitis C elimination was the vote on Thursday by the Pharmacy and Therapeutics committee to remove all restrictions on access to the curative treatments.
Currently, Oregon has the highest hepatitis C mortality rate in the country. These aggressive moves by leadership can change that unfortunate statistic and save future lives and precious healthcare resources for all Oregonians.
“We look forward to working with the legislature to ensure the funding remains in the budget and with OHA and the community to develop Oregon’s elimination strategy,” said Lorren Sandt, Executive Director of Caring Ambassadors Program. “We have all the tools now to make elimination a reality, thanks to the support of our leadership.”
About Caring Ambassadors Program
The Caring Ambassadors supports individuals in gaining control of their healthcare, regardless of the illness they face.
We provide information, tools, and resources to help those with any long-term disease not only manage their health care after a diagnosis but improve their quality of life and capacity for healing. As an advocacy organization, we both fight for patient rights and work to build a new generation of patient and healthcare champions. Our disease-specific programs for Hepatitis C and Lung Cancer have been helping people obtain the support, assistance, and information they need for over 20 years.