AUSTIN — When Peyton Howell learned a medicine could cure the hepatitis C that has ravaged his liver since birth, he thought it was too good to be true.
Sitting beside his mom last fall at a doctor’s office in Austin, the 17-year-old had just learned his condition was urgent. Peyton’s liver is on the brink of cirrhosis and getting the drug is his best chance to reversethe damage that can lead to cancer, liver failure and even death.
He left the office with a prescription, but it turns out that Peyton was right to be skeptical.
The drugmaker Merck said Thursday that it would lower prices on several drugs by 10 percent or more, but its rollback affects minor products and would not lower the cost of its top-selling, expensive cancer and diabetes products.
The move follows recent announcements by Pfizer and Novartis that they would freeze price increases for the rest of the year, as the industry confronts sustained criticism from President Trump, lawmakers and the public over the rising cost of prescriptions.
Merck’s action shows just how cautiously the industry is shifting strategies: It did not cut the prices of any blockbusters like the cancer treatment Keytruda or the diabetes drug Januvia. Instead, it said it would reduce by 60 percent the list price of Zepatier, a hepatitis C drug whose recent sales have dipped so low that, after paying after-the-fact rebates to insurers, the company recorded no sales in the United States for the product in the first quarter of this year.
This article by Dr. Ieva Tolmane et al. is published in The Open Infectious Diseases Journal, Volume 10, 2018
There has been published results of the study “ORIGINAL VERSUS GENERIC DIRECT ACTING ANTIVIRALS IN TREATMENT OF CHRONIC HEPATITIS C PATIENTS: REAL LIFE DATA FROM LATVIA” authored by Tolmane I, Rozentale B, Arutjunana S et al., recently.
There are many new highly effective direct acting antiviral medicines for hepatitis C treatment registered worldwide during recent years. Despite effective treatment available from 2016 in Latvia, there are restrictions – only patients with fibrosis (F, Metavir) stages 3 to 4 have access to reimbursed medicines. Some patients obtain generic drugs from India. The aim of this study was to evaluate the efficacy of original and generic direct acting antiviral medications in Latvian hepatitis C patients. This was a retrospective study of 179 chronic viral hepatitis C patients. Patients were divided into two groups – those who received original direct acting antivirals ombitasvir, paritaprevir, ritonavir, dasabuvir + ribavirin (n=144) and those who received generic medicines from India (n=35) sofosbuvir, ledipasvir or sofosbuvir, daclatasvir + ribavirin. Undetectable viral load 12 weeks after cessation of therapy (sustained virologic response 12) was measured in all patients. Therapy course completed 142 patients (2 patients discontinued treatment) from original medicines group and all patients from generics group. In the original medicines group – sustained viral response was achieved in all 142 patients who completed treatment course (100%), while in generic medicines group in 32 patients (91.4%).
Louisiana is working with Gilead Sciences and other companies on a deal that would change how the state pays for expensive hepatitis C drugs, with the goal of eliminating the disease in that state.
DAVID GREENE, HOST:
This week, NPR and the Center for Public Integrity have been reporting on lobbying by pharmaceutical companies in states across the country. We have found a system rife with conflicts of interest that make it hard for states to control costs in their Medicaid programs. But in Louisiana, one of the poorest states in the U.S., a deal is in the works that may change how the state pays for one very expensive medication that thousands of residents need. And in the long term, this deal could change how states and drug companies work together to rein in drug prices. Here’s NPR’s Alison Kodjak.
ALISON KODJAK, BYLINE: To get a sense of what happens when high drug prices and tight state budgets mix, Louisiana is the place to go. The state has been in a budget crisis. Lawmakers held three special sessions this year, and the Medicaid budget was a major target. Rebekah Gee is the state’s health secretary.
Study Aims and Results: The aim was to look at the relationship of the intestinal microorganisms in HCV patients compared to healthy people. Fecal (poop) sample was collected from 166 HCV patients and 23 healthy people and examined. The health status of people with HCV included normal ALTs (18 people), chronic hepatitis C without liver cirrhosis (84 people), liver cirrhosis (40 people), liver cancer (24 people). Compared to healthy people the bacterial diversity was lower in the people infected with hepatitis C. This occurred in various degrees in all stages of HCV disease progression.
Conclusions: Gut dysbiosis was diagnosed in people with hepatitis C regardless of the severity of liver disease.
Editorial Comments: Gut dysbiosis is implicated in a wide variety of disorders including inflammatory bowel disease, irritable bowel syndrome, and celiac disease. It may also include disorders outside of the intestines including allergies, metabolic syndrome, cardiovascular disease, and obesity.
Deaths from liver disease have risen sharply in the U.S., and doctors say the biggest factor is drinking —especially among young adults.
A study published Wednesday found a 65 percent increase in deaths from cirrhosis of the liver since 1999. The biggest increase is among millennials: the team found that deaths from cirrhosis are rising 10 percent a year among people aged 25 to 34.
People so young might not even realize that they can drink themselves to death so quickly, but they can, said liver specialist Dr. Haripriya Maddur of Northwestern Memorial Hospital in Chicago.