Hepatitis C: A Public Health and Healthcare Spending Time Bomb

A Public Health and Healthcare Spending Time Bomb: Hepatitis C

By Mina Marmor and Henry I. Miller

Excerpt:

The relatively obscure liver inflammation caused by hepatitis C virus (HCV) is a significant threat worldwide, and its prevalence is growing. It demands greater attention from both public health officials and drug developers..... 

Many studies have shown that HCV infection results in significantly higher rates of death from liver-related diseases, as well as increased mortality from other causes, including cardiovascular and renal disease, which may be due to persistent inflammation and immune-complex deposition......

We should soon have more effective and better-tolerated all-oral regimens that do not include interferon. Indeed, recent clinical data have shown very promising results with several interferon-free regimens, including different classes of drugs targeting various viral proteins and enzymes. These include drugs from Gilead and Abbott, both of which have  Phase III trials under way for treatments which may be commercially available by 2015.......

Data presented at recent medical meetings, including the American Association for the Study of Liver Diseases in November 2012, suggest that Gilead may be able develop an ideal HCV treatment regimen − a single, once-daily tablet that is well-tolerated, safe, and highly efficacious. At the least, Gilead is expected to capture a significant portion of the HCV market with regimens containing sofosbuvir (GS-7977), the nucleoside polymerase inhibitor acquired in the $11 billion takeover of Pharmasset. Bristol-Myers Squibb BMY +0.88%, Johnson and Johnson, Vertex and other companies are also working on all-oral HCV treatment regimens........

In addition to the clinical benefits, pharmaco-economic analyses also support treatment of HCV. Infected patients incur higher healthcare costs compared with a non-infected population matched by sex, age, and healthcare enrollment. Because costs are driven largely by end-stage liver disease, liver transplants and cancer, total HCV-related healthcare expenditures are likely to increase significantly over time as patients progress to more severe disease. The stringent assessment by the UK’s National Institute for Health and Clinical Excellence showed robust cost-effectiveness for treating HCV with either telaprevir or boceprevir. This analysis supported treatment of various patient sub-populations, including treatment-naïve patients with mild disease. Depending on the price points, the higher cure rates and reduced incidence of adverse events associated with oral direct-acting antivirals may lead to even greater cost-effectiveness in future.....

Full article available @ Forbes