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Changes in Hepatitis C Treatment Offer New Hope

New guidelines for treating the disease is welcome relief for millions, but will insurers pay for it?



By Paul Gaita


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A new set of guidelines for the treatment of chronic hepatitis C may offer more effective relief for the more than four million individuals in the United States, including IV drug users, who suffer from its debilitating effects.

The guidelines, published by a committee comprised of the American Association for the Study of Liver Diseases, the Infectious Diseases Society of America, and the International Antiviral Society suggest that the use of newer oral medications, including sofosbuvir and simprevir – both recently approved by the Food and Drug Administration (FDA) – could provide faster treatment for hepatitis C while eliminating the need for interferon injections, which have a host of adverse effects ranging from flu-like symptoms to immunosuppression. The guidelines are recommended for hepatitis C patients with genotype 1 – the most common strain of the virus – as well as those who cannot tolerate interferon.

Patients seeking alternative treatment for hepatitis C should note that the guidelines do not address a time frame for effectiveness or which patients should receive immediate treatment, which is a significant factor given the varying degrees in severity to which the virus affects the body. They also do not factor the cost of treatment, which is a subject of considerable debate among health providers and advocates. The suggested combination of sofosbuvir and simeprevir could come with a price tag of $150,000 for 12 weeks of medication; an amount that many insurers are refusing to pay.

While many private insurers in FDA-approved combinations cover the drug, the agency has yet to approve any regimen that does not include interferon. The committee hopes to address this and other issues in future versions of the guidelines while underscoring that the first line of defense against hepatitis C remains testing.

As heroin-related deaths skyrocket across the northeastern United States, so too does the number of hepatitis C infections among intravenous drug users. Intranasal cocaine users who share instruments for snorting the drug are also at higher risk for acquiring the virus.

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