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 21 May 2018

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News

Hep C treatment transformation in a national healthcare system after direct antiviral agents

A study in the latest issue of the Alimentary Pharmacology & Therapeutics examines the transformation of hepatitis C antiviral treatment in a national healthcare system following the introduction of direct antiviral agents.

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Highly effective direct antiviral agents for hepatitis C virus (HCV) were introduced recently. Their utilisation has been limited by high cost and low access to care.

Dr Ioannou and colleagues from Washington, USA described the effect of direct antiviral agents on HCV treatment and cure rates in the United States Veterans Affairs national healthcare system.

The researchers identified all HCV antiviral treatment regimens initiated from 1999 to 2015 in the Veterans Affairs' national healthcare system, and determined if they resulted in sustained virological response.

HCV antiviral treatment rates were low in the interferon era. 

The team found that the introduction of simeprevir and sofosbuvir in 2013 and ledipasvir/sofosbuvir and paritaprevir/ombitasvir/ritonavir/dasabuvir in 2014 were followed by increases in annual treatment rates to 9180 in 2014, and 31,028 in 2015. 

The number of patients achieving sustained virological response was 1313 in 2010, the last year of the interferon era, and increased 6-fold to 7377 in 2014, and 21-fold to 28,084 in 2015. 

The proportion of treated patients who achieved sustained virological response increased to 91% in 2015
Alimentary Pharmacology & Therapeutics
The researchers reported that the proportion of treated patients who achieved sustained virological response increased from 19% in 1999 and 36% in 2010 to 91% in 2015. 

Within 2015, the team observed that monthly treatment rates ranged from 727 in July to 6868 in September correlating with the availability of funds for direct antiviral agents.

Dr Ioannou's team comments, "Direct antiviral agents resulted in a 21-fold increase in the number of patients achieving HCV cure."

"Treatment rates in 2015 were limited primarily by the availability of funds."

"Further increases in funding and cost reductions of direct antiviral agents in 2016 suggest that the Veterans Affairs could cure the majority of HCV-infected Veterans in care within the next few years."

Aliment Pharmacol Ther 2017: 45(9): 1201–1212 
06 April 2017

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