Doctors who treat hepatitis C are hailing the development of drugs that can effectively eradicate the infection, which is a leading cause of cirrhosis and liver cancer worldwide. At the same time, their focus now has turned to reducing the high cost of treatment so that it’s accessible to developing countries, where 80 percent of people are infected.
An estimated 150 to 185 million people worldwide are infected with hepatitis C and many don’t know it. That’s because the virus is largely silent until late symptoms appear, including grinding fatigue, joint pain, abdominal pain and jaundice, a yellowing of the skin and eyes.
But pivotal studies of new antiviral drugs conducted in developed countries show they knock out upwards of 90 percent of all hepatitis C infections, promising to revolutionize treatment in low- and middle income countries.
Channa Jayasekera is with the Division of Gastroenterology and Hepatology at Stanford University in California.
Jayasekera spoke via Skype from the International Liver Congress meeting in London, where the new treatment options for hepatitis C are getting a lot of attention.
“This is really a landmark achievement in all of medicine, I would say, because it’s one of the few times where we’ve been able to definitively eradicate a disease with a short course of oral therapy," said Jayasekera.
Experts say the oral medications may even be more effective in the developing world because people there harbor different, possibly more responsive, types of the virus than in the West.
But a three-month course of the second generation antiviral drugs in the West costs between $85,000 and $90,000, according to Jayasekera.
However, with the issuance of guidelines by the World Health Organization for the diagnosis and treatment of hepatitis C with oral medications in low- and moderate income countries, there are moves to bring down the cost.
Jayasekera says competition among the handful of pharmaceutical companies, and negotiations between manufacturers and governments as well as insurers, eventually will make treatment affordable.
The companies that produce the pills, according to Jayasekera, also are in the process of securing licenses for the manufacture of generic drugs for distribution in countries where they are most needed.
“So, if a company that is selling these drugs feels that it is ethical and moral and in the spirit of corporate social responsibility appropriate to ensure that these drugs are also available to people outside of richer countries, then that prerogative is there," said Jayasekera.
Jayasekera adds it will be necessary for each country to prioritize who gets treated first, in order to hold down costs and not overwhelm health care systems.
Jayasekera made his observations in an article in New England Journal of Medicine.