Hepatitis C cure for under $300 US fuels excitement

A combination hepatitis C cure that is so costly it’s rationed in Canada will be available in middle-income countries for less than $300 US, a move that opens the window to more affordable treatment in this country, Doctors Without Borders says.

A combination hepatitis C cure that is so costly it's rationed in Canada will be available in middle-income countries for less than $300 US, a move that opens the window to more affordable treatment in this country, a physician with Doctors Without Borders says.

There are an estimated 301,000 cases of Hepatitis C cases in Canada. The silent killer often doesn't cause symptoms until the liver is severely damaged. Chronic infection can cause inflammation of the liver, scarring of the organ, cirrhosis and other complications, including liver cancer.

Treating the hepatitis C virus used to require frequent injections and daily pills that had to be taken for up to a year with flu-like side-effects. Once more tolerable drugs that could eliminate the infection in most patients in about 12 weeks were introduced in 2013, a liver specialist considered the elimination of hepatitis C in Canada a realistic goal

But the retail price for an eight- to 24-week regimen of the anti-virals ranged from $55,000 to $80,000 in 2015. The steep price means provincial pharmacare programs cover the drugs only for patients with a moderate level of liver disease

Now the non-profit organization Drugs for Neglected Diseases Initiative and Egyptian drug maker Pharco Pharmaceuticals have signed agreements to provide a combination of the Hepatitis C drugs sofosbuvir and the antiviral ravisdasvir for further clinical tests for $300 US or less per treatment course.

There was excitement when the agreement was announced this week at the International Liver Congress in Barcelona, Spain, said Dr. Isabelle Andrieux-Meyer, HIV and hepatitis C medical advisor for Doctors Without Borders.

The drugs make such a difference in wealthy countries but the contrast in lower and middle income countries is "brutal," Andrieux-Meyer said from the conference on Friday.

"So many patients can't buy treatment," she said.

More people could be treated, B.C. nurse says

Pharco's phase III clinical trial in Egypt showed cure rates of up to 100 per cent in patients with the "genotype 4" form of Hepatitis C who took two pills a day. Egypt is the world's worst affected country with an estimated 6 million cases.  

Under the agreement, the company agreed to set the commercial price at $294 US or less per treatment course once the scale-up is approved. The drug combinations were first priced in the U.S. at $80,000 US per treatment course. 

The drugs will first be sold in Malaysia and Thailand. 

Doctors Without Borders is a member of the Drugs for Neglected Diseases Initiative, which has licensed rights for ravisdasvir in low- and middle-income countries from Presidio Pharmaceuticals.

"In 2018, they could renegotiate with Presidio a license that could include middle income and high income countries including Canada. So this means, it's not done, but it's possible. It's like a window which starts to open, and this is important," Andrieux-Meyer said.

Yashna Bhutani is a registered nurse at the Vancouver Infectious Diseases Centre, where more than half of the patients they see have hepatitis C. Bhutani said many patients are disappointed when they learn they don't qualify for drug coverage.

Bhutani welcomes the possibility of a cheaper alternative.

"I think that would be obviously really amazing in the long run for the patients because more people could actually get treated and more people will be able to afford it," Bhutani said.

Globally, about 130 to 150 million individuals have a chronic Hepatitis C virus infection and 350,000 to 500,000 people die annually from illnesses related to the virus, the World Health Organization says, based on a 2010 study.

The conference ends Sunday. 

With files from CBC's Vik Adhopia and Associated Press