Hepatitis C: Choice of Expensive Treatments

Hepatitis C is a disease caused by a virus that infects the liver.  The virus, called the Hepatitis C virus or HCV for short, is just one of the hepatitis viruses. According to the Centers for Disease Control (CDC), an estimated 2.7 million people in the United States have chronic Hepatitis C infection.

Some people who get HCV have it for a short time (up to six months) and then get better on their own.  This is called acute Hepatitis C.  But most people (about 75% – 85%) will go on to develop chronic (or long-term) Hepatitis C, meaning it doesn’t go away without proper and expensive treatment.

Unless successfully treated with medication, chronic Hepatitis C infection can cause other serious health problems, such as cirrhosis, liver cancer and liver failure. However, with recent advances in Hepatitis C treatment the cure rates are higher now a days.

Unlike Hepatitis A and Hepatitis B, a vaccine for Hepatitis C is not available.

Hepatitis C infection is treated with antiviral medications intended to clear the virus from your body.  Your doctor may recommend one medication or a combination of two to three medications to be taken for 12 – 24 weeks or longer.


Choice Of Treatment:
Until a few years ago, there were only two drugs approved by the FDA for Hepatitis C treatment:
1. Pegylated interferon (Peg-IFN)
2. Ribavirin (RBV)

On May 2011, FDA approved two new medications that are part of a drug group called protease inhibitors: VICTRELIS (boceprevir) and INCIVEK (telaprevir)

On November 2013, the FDA approved the first once-daily protease inhibitor: OLYSIO (simeprevir)

On December 2013 the FDA approved a new medication that is a part of a drug group called polymerase inhibitors.  It works by blocking a specific protein the Hepatitis C virus needs to grow.  It is called: SOVALDI (sofosbuvir)

On October 2014: the FDA approved the first combination pill to treat Hepatitis C, offering people with HCV genotype 1 an all-oral treatment regimen: HARVONI (ledipasvir/sofosbuvir)

On November 2014, the FDA granted simeprevir (OLYSIO) an additional approval to be used in combination with sofosbuvir (SOVALDI) as a once-daily, all-oral, interferon and ribavirin-free treatment for adults with genotype 1 HCV infection.

On December 2014, the FDA approved a new combination medicine, which can be given with or without ribavirin, to treat adults with genotype 1 HCV infection, including people who have a certain kind of cirrhosis (compensated): VIEKIRA PAK (ombitasvir/paritaprevir/ritonavir tablets; dasabuvir tablets)

On July 2015, the FDA approved two new drugs – TECHNIVIE for the treatment of HCV genotype 4 and DAKLINZA for the treatment of HCV genotype 3.

On January 2016, the FDA approved a new medicine to treat adults with chronic HCV genotypes 1 or 4 infection, including those with compensated cirrhosis, HIV-1 co-infection, or severe kidney disease and on dialysis: ZEPATIER (elbasvir 50 mg/grazoprevir 100 mg)

On June 2016: The FDA approved a new combination medicine, the first therapy approved to treat all HCV genotypes (1, 2, 3, 4, 5, or 6).  It is also the first single tablet regimen approved for the treatment of patients with HCV genotype 2 and 3, without the need for ribavirin: EPCLUSA (sofosbuvir 400mg/velpatasvir 100 mg) 

Cost Of Treatment:
HARVONI:
The wholesale acquisition cost (WAC) for ledipasvir-sofosbuvir is $1125 per pill.
Cost of 8-week course of therapy = $63,000.
Cost of 12-week course of therapy = $94,500.

Sovaldi:
Sovaldi costs $84,000 for a 12-week course of treatment, or about $1,000 per pill.

EPCLUSA:
12-week regimen of Epclusa to cost ~ $74,760.

ZEPATIER:
This is cheaper compare to other HEP-C Drug. Approximate cost $54,600 per treatment.