CATIE News

7 March 2019 

Maviret for hepatitis C treatment enters the Ontario drug formulary

  • Potent hepatitis C medication Maviret now covered by Ontario’s public drug plan
  • In some patients, the treatment can cure hepatitis C in as few as eight weeks
  • Maviret can be used for all viral genotypes and in people with kidney disease

Hepatitis C virus (HCV) infects the liver, where it can develop into a chronic infection. This infection incites inflammation in the liver, injuring this organ over time as healthy liver tissue is replaced with useless scar tissue in a process called fibrosis. If left untreated, chronic HCV infection causes the entire liver to become scarred (a condition called cirrhosis), which leads to several complications, such as severe fatigue, recurrent abdominal infections, internal bleeding and problems thinking clearly, as well as liver failure and death. Chronic HCV infection also increases the risk for liver cancer.

In the past five years, increasingly potent, safe and simple anti-HCV treatments have been licensed in Canada and other high-income countries, including at least the following:

  • Epclusa – made by Gilead Sciences
  • Harvoni – made by Gilead Sciences
  • Maviret – made by Abbvie
  • Zepatier – made by Merck

These treatments are expensive. Fortunately, many ministries and departments of health generally subsidize the cost of treatment for chronic HCV infection (and other catastrophic conditions such as cancer and HIV infection). The list of subsidized medicines is called a drug formulary.

Enter Maviret

Maviret is the brand name of a pill containing two powerful anti-HCV drugs—glecaprevir and pibrentasvir. It is approved in Canada for the treatment of HCV. Maviret is taken at a dose of three pills once daily with food (the kind of food does not matter) and is generally well tolerated. In patients who have chronic HCV infection without severe liver injury (cirrhosis) and who are new to treatment, Maviret can be prescribed as an eight-week course, regardless of the strain (genotype) of HCV. As well, Maviret can be used in people with chronic HCV who also have chronic kidney disease— a problem that can occur in some people with HCV—regardless of the stage of kidney disease.

Negotiation

To help reduce the cost of drugs that the ministries of health subsidize, Canada’s provinces and territories bargain collectively with pharmaceutical companies through the pan-Canadian Pharmaceutical Alliance (pCPA).

The pCPA recently completed its negotiations with Abbvie and the province of Ontario will have Maviret listed on its formulary on 28 February 2019. It will be listed both for people new to HCV treatment and for people who are treatment experienced, regardless of the degree of liver injury (fibrosis).

In the coming weeks and months, other provinces will hopefully add Maviret to their formularies.

The listing of Maviret on provincial and territorial drug formularies offers doctors and patients another option for the treatment of HCV.

CATIE resources

Maviret (glecaprevir + pibrentasvir)Factsheet

Hepatitis C drugs approved in Canada for adultsDrug chart

Hepatitis C: An In-Depth Guide

—Sean R. Hosein

REFERENCES:

  1. Abbvie. AbbVie reaches an agreement with the pan-Canadian Pharmaceutical Alliance (pCPA) for its hepatitis C treatment Maviret. Press release. 21 February 2019.
  2. Abbvie. Maviret – Antiviral agent. Product monograph. 28 November 2018.