Friday, September 15, 2017

HCV TGIF: Patient Voice Lacking in HCV Cost-effectiveness Research, Baby Boomers, and Liver Cancer

TGIF! Here's your HCV news with blog updates from around the web.

HCV Review
Sept 15
If you are interested in a weekly news recap start with HepCBC.

In The News
Viral hepatitis accounts for 1.34m deaths globally
Sep 16
Viral hepatitis with 1.34 million deaths globally has surpassed all chronic infectious diseases including HIV/AIDS, malaria and tuberculosis, according to a study by Global Burden of Disease.

'Exciting' discovery on path to develop new type of vaccine to treat global viruses
Sept 15
Scientists at the University of Southampton have made a significant discovery in efforts to develop a vaccine against Zika, dengue and Hepatitis C viruses that affect millions of people around the world.

Update on the Cost Burden of HCV Treatments
Sept 15
With the recent availability of the interferon-free combinations of direct-acting antivirals (DAAs) for hepatitis C viral infection (HCV), patients now have a highly effective treatment without the dismal side effects that interferon-based therapies offered in years past.

Of Interest
Will Express Scripts and CVS Health open their Hep C Virus therapeutic class and add Marvyet alongside Harvoni?
AbbVie’s Mavyret Drug Pricing: A Challenge to the Pharmacy Benefit Manager Business Model
Sept 15
AbbVie’s pricing for its new Hepatitis C Virus drug Mavyret is disruptive to the current PBM business model because it forces the Big 3 PBMs to consider a drug for inclusion in their national formularies that is aligned with their clients interests — more cost-effective that Harvoni — but not aligned with their own interests — needing to squeeze out all the rebates they can from specialty drug therapeutic classes. At the very least, will Express Scripts and CVS Health open their Hep C Virus therapeutic class and add Marvyet alongside Harvoni? Or, will they expose themselves to claims of misalignment by excluding Mavyret?

Newly approved hepatitis drugs mark a milestone in treatment and access
Briefly Sep+Oct 2017
The Gilead Sciences HCV medication Vosevi (sofosbuvir 400 mg/velpatasvir 100 mg/voxilaprevir 100 mg) was approved on July 18 for the re-treatment of HCV in treatment-experienced people. Just two weeks later on August 3, the FDA approved the Abbvie medication Mavyret (glecaprevir 300 mg/pibrentasvir 120 mg) for the treatment of both treatment-naïve and treatment-experienced patients, including people living with HIV/HCV co-infection.

All too often, patients and advocates are told the medications are too expensive to cover and will wipe out Medicaid budgets, denying people treatment and/or making them wait until their liver health worsens so as to be eligible. This price significantly weakens this argument.
Again, there is nobody we can’t treat, and now we can afford to do it.

New At Behind The Headlines
Mice exposed to third-hand smoke developed brain and liver damage
Sept 15
"Third-hand smoke exposure can cripple your brain and liver, affecting your mannerisms, increasing your risk of neurodegenerative diseases, and ruining your metabolism," the Mail Online reports. But the study it reports on involved mice not people.

New At MD Magazine
A review of more than 1,000 studies found the vast majority of economic analyses of HCV therapies don’t incorporate patient input.

Worldwide HCV prevalence in 2017 dropped 2% from 2015 levels to 69.6 million viremic infections, thanks to increased treatment and prevention.

The fixed-dose combination of ombitasvir/paritaprevir/ritonavir (OBV/PTV/r) (Technivie, AbbVie), which is approved to treat HCV genotype 4, was combined with the pangenotypic DAA, sofosbuvir (SOF) (Sovaldi, Gilead), in addition to ribavirin for 12 weeks in patients having genotype 3 with cirrhosis, and with or without ribavirin in type 3 patients without cirrhosis. In addition, the regimen with ribavirin was administered for either 6 or 8 weeks to genotype 2 patients without cirrhosis.

New at Healio
Mavyret (glecaprevir/pibrentasvir), Vosevi (Sofosbuvir/Velpatasvir/Voxilaprevir) and Liver cancer:
HCV NEXT September/October Issue - Two Approvals Offer Even More Options for HCV Treatment

Of Interest
CATIE's HepCInfo Update 8.18 for August 19 to September 1, 2017. Read on to learn more about new and updated scientific findings in hepatitis C prevention, care, treatment and support.

"Eradication of HCV has been shown to reduce the risk of hepatocellular carcinoma, to improve liver fibrosis, and to decrease the risk of other complications of chronic liver disease (39). However, the effects of HCV eradication on the extrahepatic manifestations of HCV have not been well studied in the new era of DAAs. Our study supports the idea that HCV eradication leads to a reduction in HbA1c in patients with diabetes."

Liver Cancer
"Most HCV-infected patients in the United States will undergo DAA-based antiviral treatment in the next few years and the vast majority of them will achieve SVR. Our results suggest that DAA-induced SVR is associated with a 71% reduction in HCC risk (AHR 0.29, 95% CI 0.23-0.37) compared to treatment failure. The reduction in HCC risk associated with SVR was similar irrespective of whether SVR was achieved by DAA-ONLY, DAA+IFN or IFN-ONLY regimens. This suggests that eradication of HCV reduces HCC risk independently of how it is achieved. In contrast to prior reports that suggested an increased HCC risk in patients treated with DAAs[[3], [7]], we found that receipt of DAA-ONLY antiviral treatment was not associated with increased risk of HCC when compared to receipt of IFN-ONLY antiviral treatment.....We found no evidence that treatment with DAAs was associated with increased risk of HCC compared to treatment with IFN.

More Than Okay to Reduce Sorafenib Dose for Liver Cancer
In the treatment of hepatocellular carcinoma (HCC), it's "safe and reasonable" to start sorafenib (Nexavar, Bayer) at reduced dosages, conclude authors of a new retrospective analysis of nearly 5000 patients. Reduced dosing was not associated with inferior overall survival compared with standard dosing, report the study authors, led by Kim Reiss Binder, MD, a medical oncologist at the University of Pennsylvania in Philadelphia.

Review Article
Viral hepatitis and liver cancer - hepatitis B and C virus
Published:19 October 2017; volume 372, issue 1732

Medscape Medical News
Sofosbuvir Safe, Effective for HCV in Those With CKD
Sofosbuvir-based antiviral therapy cured hepatitis C virus infection in more than 80% of patients with chronic kidney disease, a retrospective cohort study found.

Lower GI Reading Room
Integrated care in prison systems key to reducing rates, transmission risk post-release

Medscape Gastroenterology
Updated Advice on Managing Liver Disease During Pregnancy
Dr Rowen Zetterman reviews the new American College of Gastroenterology guidelines on caring for pregnant patients with diseases ranging from liver masses to viral infections.

New at aidsmap
High prices of DAAs mean there's been little progress towards achieving WHO target of eliminating HCV by 2030
Sept 15
Only a handful of countries are on course to achieve the World Health Organization (WHO) target of eliminating hepatitis C virus (HCV) as a major public health concern by 2030, according to a study published in the Journal of Virus Eradication. Investigators estimated progress towards elimination by examining 2016 data on rates of cure after therapy with direct-acting antivirals (DAAs), HCV-related deaths and new HCV infections. An overall reduction in prevalence of 0.71% was observed in the 91 countries included in the study, and global prevalence fell by just 0.4%.

New at The Body PRO
This Week in HIV Research: 'Massive Loss of Life'
Sept 15
This week, a study finds that reducing U.S. foreign aid for HIV-fighting efforts is a really bad idea no matter which way you cut it. We also examine meta-analysis data regarding pregnancy and the "old" tenofovir; newly published findings regarding cancer risk among people with HIV; and data regarding the potential viability of a neighborhood-specific approach to reduce HIV disparities in the U.S. To beat HIV, you have to follow the science!

On Twitter
Tweets By - Henry E. Chang
In Case You Missed It  - DAA therapy for chronic HCV infection results in liver stiffness regression over 12 months post-treatment

Full Text Articles
I highly suggest you follow Henry E. Chang on Twitter if you are interested in reading full text articles about the treatment and management of hepatitis C.

Baby Boomers - New At 
Out of 3.5 million Americans chronically infected with HCV, 80% are “baby boomers” (born between 1945 and 1965). If you were born between 1945 and 1952, you're now eligible for a senior citizen discount. Turning 65 does have its perks, especially grandchildren, right? If you're a grandparent living with the hepatitis C virus, Karen Hoyt, has a few tips for you; What to Tell Your Grandchild About Hepatitis C. Jump over to and view all blog updates, here.

HCV Stigma - New at HEP
HCV Stigma is in the spotlight over at Hep, Rick Nash, always positive, writes about stigma from a fresh prospective; Stigma: It’s not me, it’s you. In addition, "Science over Stigma explores the discriminatory, biased, and unnecessary practice of requiring a period of sobriety prior to receiving HCV curative treatment." Read the article, here.

Triaging Hepatitis C Treatment: Why the Fibrosis Score Is Not Valid, is a look at the bottom line results, what they mean for patients seeking treatment, written by devoted HCV advocate Greg Jefferys. Read additional blog articles at Hep, here.

October issue of Attitude
Gay men with hepatitis C are suffering stigma not seen since the HIV/Aids crisis, read the article published in the latest issue of Attitude.

New At Hepatitis B Foundation 
Over at Hepatitis B Foundation is a three part series with easy to read information about the hepatitis B virus, last week part three was published: Part I is about how the virus is transmitted, and may have helped you determine how you were infected with HBV. In Part II we will discuss the people closest to you who may be susceptible to your infection. Part III is about preventing future transmission to others. View all blog updates, here.

The Doctor Weighs In
Sept 15
Examining the Federal Response to the Opioid Crisis
The disease of addiction has claimed so many young lives and shows no signs of relenting. Today, overdoses are the leading cause of death in Americans under the age of 50. An addiction specialist on the front lines of battling the opioid epidemic in Ohio provides her perspective on Drug Addiction Commission's interim report.

In Case You Missed It

No comments:

Post a Comment