6 March 2017
Improved access to hepatitis C treatment coming to B.C. and Ontario
Researchers estimate that there are more than 200,000 people in Canada living with hepatitis C virus (HCV). This virus infects the liver and gradually destroys this vital organ, leading to severe complications, including internal bleeding, infections, liver failure and, in some cases, increased risk of liver cancer.
Historically, treatment for HCV infection has been a combination of two drugs—weekly injections of interferon and daily oral doses of ribavirin for up to 48 weeks. However, this combination tended to cause severe side effects, particularly affecting mood, and was not highly effective.
A revolution in treatment and prices
Several years ago pharmaceutical companies began introducing all-oral regimens for HCV treatment. The most current drugs are highly effective, with cure rates around 95% and greater. These drugs have few side effects and can cure people in as little as two to three months.
Unfortunately, the list price of these drugs has been very high. As a result, treatment for HCV has been rationed by Canada’s provinces and territories, with patients having to develop a moderate-to-severe degree of liver injury before they can receive subsidized treatment.
Canada’s provinces, territories and federal government drug plans collectively negotiate drug prices with the pharmaceutical industry through a body called the pan-Canadian Pharmaceutical Alliance (pCPA). In a recent development, the pCPA reached a deal with several pharmaceutical companies that agreed to charge Canada’s provinces and territories (and the federal government’s drug plans) lower prices for HCV medications.
Changes to access in the works
As a result of this deal, the B.C. government has decided to add more treatments to its lists of subsidized medicines. Another consequence of the deal is that the B.C. government made the following statement:
“PharmaCare is expanding the criteria in March 2017 to provide coverage to more patients living with hepatitis C. Physicians can apply for coverage of the new drugs on behalf of their patients on or around March 21, 2017. Starting in 2018-19, PharmaCare will provide coverage for any British Columbian living with chronic hepatitis C, regardless of the type or severity of their disease.”
In late February the government of Ontario added more HCV drugs to its list of subsidized medicines. As in B.C., the government of Ontario is committed to lifting restrictions on access to HCV treatment over the coming year.
At this time no other provinces or territories had made announcements as a result of the latest negotiations with the pCPA.
The drugs that were part of the recent negotiations with the pCPA include the following:
- a fixed-dose formulation of ledipasvir + sofosbuvir (sold as Harvoni)
- a fixed-dose formulation of sofosbuvir + velpatasvir (sold as Epclusa)
- a fixed-dose formulation of elbasvir and grazoprevir (sold as Zepatier)
- sofosbuvir (sold as Sovaldi)
- daclatasvir (sold as Daklinza)
- asunaprevir (sold as Sunvepra)
- CATIE’s hepatitis C information
- Hepatitis C: An In-Depth Guide
- The epidemiology of hepatitis C in Canada – fact sheet
- Epclusa (velpatasvir + sofosbuvir) –fact sheet
- Harvoni (ledipasvir + sofosbuvir) – fact sheet
- Zepatier (elbasvir + grazoprevir) – fact sheet
- Daclatasvir (Daklinza) – fact sheet
- Sofosbuvir (Sovaldi) – fact sheet
—Sean R. Hosein
- Grant K. Deal reduces price of life-saving hepatitis C drugs for Canadians. Globe and Mail. 21 February 2017.
- Ontario Public Drug Programs. Notice from the executive officer: Funding of hepatitis C drug products under the Ontario Drug Benefit Program. Notice. 21 February 2017. Available at: http://www.health.gov.on.ca/en/pro/programs/drugs/opdp_eo/notices/exec_office_20170227.pdf
- Government of British Columbia. More patients to benefit from hepatitis C treatments. Press release. 21 February 2017. Available at: https://news.gov.bc.ca/releases/2017HLTH0037-000374
- Philpott J. Government of Canada partners with provinces and territories to lower cost of pharmaceuticals. Press release. 19 January 2016. Available at: http://news.gc.ca/web/article-en.do?nid=1028339