HepCInfo Update 8.5
Welcome to CATIE's HepCInfo Update 8.5 for February 18, 2017 to March 3, 2017. Read on to learn more about new and updated scientific findings in hepatitis C prevention, care, treatment and support.
New and noteworthy
The pan-Canadian Pharmaceutical Alliance (pCPA), the body which represents provinces and territories in negotiations with pharmaceutical companies has reached a deal with several companies for lower prices for six hepatitis C medications.
Following these negotiations, B.C. added these medications to the provincial formulary and in 2018 will no longer require a person to have a certain level of liver injury to qualify for treatment.
Ontario will also extend coverage to all people with hepatitis C within the next 12 months. Ontario has also added asunaprevir, daclatasvir, Epclusa and Zepatier to the drug formulary as of February 28th, 2017. Eligibility for these medications still includes a moderate level of liver injury (F2 fibrosis score), however there are many exceptions where this is not required, such as, people who also have HIV, hepatitis B or kidney disease.
It is unclear whether other provinces and territories will extend coverage in a similar way. Whenever the pCPA negotiates a deal with manufacturers, each province and territory has to decide how to implement the changes to its own drug formulary. (catie.ca, February 2017)
If hepatitis C treatment uptake continues at its current rate, Australia may be able to eliminate hepatitis C by 2026, reported researchers from the Kirby Institute of the University of New South Wales.
The report estimates that between 30,000 and 33,000 people started treatment with direct-acting antivirals (DAAs) in 2016 (March to December). This number corresponds to between 13% and 15% of people living with hepatitis C in Australia.
Of people beginning treatment the majority were men (66%) and 40% were 50 years old or older.
The most commonly used treatments were Harvoni (57%) and sofosbuvir and daclatasvir (38%). Overall, 65% of individuals received treatment from a specialist. However, the proportion of people receiving treatment from General Practitioners (GPs) increased from 4% in March to 19% in September.
"We have a unique opportunity to eliminate a major infectious disease, potentially the first opportunity through treatment intervention," concluded one of the researchers. (kirby.unsw.edu.au, February 2017)
The U.S. Food and Drug Administration has updated the Technivie label to include the option to treat people with genotype 4 virus and severe liver injury (cirrhosis).
People with genotype 4 virus and cirrhosis take Technivie and ribavirin for 12 weeks.
The update was based on data from a clinical trial that included 120 participants with cirrhosis who took Technivie once daily with ribavirin for 12 or 16 weeks.
The cure rate for people who took this treatment for 12 weeks was 97% (57/59). The cure rate for the 16 week treatment was not presented in the report.
The most common side effects were fatigue, weakness and headache.
Technivie and ribavirin is currently approved in Canada for people with genotype 4 virus who do not have cirrhosis. (content.govdelivery.com, February 2017)
Straight to the source for new science
The cost impact of outreach testing and treatment for hepatitis C in an urban Drug Treatment Unit, Liver International, March 2017