New drugs promise a cure for hepatitis C

Hepatitis C infections could become rare in the United States over the next two decades as recently approved medications promise to cure the disease and give sufferers a new lease on life, according to a recent study published in the Annals of Internal Medicine. Meanwhile, researchers at the University of Pittsburgh Graduate School of Public Health say the new drugs could prevent 126,500 deaths from hepatitis C by 2050.

Hepatitis C is a viral infection that can lead to cirrhosis and liver cancer. Among the people with the infection, 60 percent to 70 percent will develop chronic liver disease, according to the federal Centers for Disease Control and Prevention.

Today, most people who contract hepatitis C get it from sharing hypodermic needles, although in the past it was commonly spread through blood transfusions and organ transplants.

Currently, hepatitis C affects one in 100 people — more than 3 million —in the United States. Those numbers could be down to one in 1,500 by 2036 because of better screening methods and a trio of powerful new drugs, said senior researcher Jagpreet Chhatwal, one of the authors of the Annals of Internal Medicine report.

In October 2014, the U.S. Food and Drug Administration approved the drug Harvoni, which contains the drugs ledipasvir and sofosbuvir. It is the first combination medication available in a single pill to offer a cure for hepatitis C. A pair of other medications approved by the FDA in late 2013 — Olysio (simeprevir) and Sovaldi (sofosbuvir) —must taken in combination with other medications.

New treatments, high prices
Past treatments for hepatitis C consisted of interferon-based medications. Even after a yearlong regimen of painful injections, the cure rate was only between 40 percent and 50 percent. Contrast that outcome with today’s options, which clear the disease in nearly all patients in as few as 12 weeks.

However, that effectiveness comes at a price.

The cost for Olysio (which must be used in combination with peg-intron and ribavirin) runs $85,000 for a 28-week treatment course. Sovaldi is sold for $1,000 per pill, or $84,000 for a 12-week supply. When paired with ribavirin, that cost is nearly the same as Harvoni’s whopping $95,000 price tag.

Insurers are balking at the high cost of the new drugs. America’s Health Insurance Plans, an insurance industry trade group, has been critical of the high prices.

“Everybody is trying to figure out how best to deliver needed treatments without blowing out resources because of the cost,” said AHIP spokesman Brendan Buck in an interview with National Public Radio.

Drug companies respond
Gilead Sciences, which makes both Sovaldi and Harvoni, defended its pricing in a policy brief, stating, “The price of Gilead’s hepatitis C treatments reflects the significant clinical, economic and public health value of these drugs, and is comparable to, or in many cases less than, the cost of older, less effective regimens.”

Those sky-high prices may not last long, though. Doctors and pharmacists are already looking forward to prescribing competing medications, including a new three-and-one pill from drug-maker AbbVie, which is currently awaiting FDA approval. The AbbVie treatment is three pills in the morning and one pill in the evening. It’s expected to hit the market in the near future and could be considerably cheaper than the alternatives.

That’s good news for hepatitis C sufferers who don’t want to be forced to put a price tag on their health.

Michael Kerr writes about healthcare, technology and business for publications including, Portland Business Journal and Bplans, among many others.