India has developed a new treatment landscape of hepatitis C virus infection that is expected to bring down treatment cost significantly.
New Delhi: In a development with far-reaching implications, researchers in India have developed a cost-effective treatment for people with hepatitis C, a blood-borne viral infection that is expensive to treat and kills by damaging the liver.
Researchers at the Sanjay Gandhi Post Graduate Institute of Medical Sciences in Lucknow have found the treatment of Hepatitis C virus (HCV) infection with directly-acting antivirals (DAAs) at the prices prevalent in India affordable and cost-effective.
Hepatitis is broadly categorised as water-borne A&E and blood-borne B&C.
While Hepatitis viruses A&E produce self-limiting symptoms, blood-borne viral infections B&C lead to chronic liver diseases and are a major cause of worry.
The infection, if not handled in time, may progress to liver cancer.
“An estimated 54 million people in India are affected by viral Hepatitis B&C. Of the two strains, only hepatitis C has a cure but it can get very expensive,” says Dr SK Sarin, director, Institute of Liver and Biliary Sciences (ILBS).
The study is published in the open-access journal PLOS ONE and finds the upfront costs of DAA are offset by the avoidance of costs incurred to treat late-stage disease.
Three DAAs (sofosbuvir, ledipasvir and daclatasvir) are available from several generic manufacturers in India. The DAA cost used for the study was US $300 for a 12 week treatment course.
The treatment of HCV infection has evolved at an extremely rapid pace over the past few years.
The development of DAAs has led to the replacement of interferon (that’s commonly used) with well-tolerated oral therapies that have cure rates of over 90% in patients.
“Availability of DAAs has changed the treatment landscape of hepatitis C virus infection. It is a hope for all patients with hepatitis C infection, including in India,” says Dr Henk Bekedam WHO Representative to India.
Elaborating further, Dr Bekedam says, “HCV treatment is also a prevention measure since people cured will not transmit the disease.”
Hepatitis C virus infects more than 70 million people worldwide; in India, the figure is an estimated 8-12 million. It is one of the leading causes for liver cirrhosis, liver cancer and liver related deaths worldwide.
In India, HCV infection was responsible for 59 000 deaths in 2015.
Until now, access to HCV treatment has been very limited globally and also in India. The high price of DAAs has restricted their use in many countries.
With India producing generic DAAs, the treatment is very affordable . Currently, the Punjab government offers a 12 week treatment course with DAAs for $120.
“HCV treatment should be a priority from a public health and human perspective as well as an economic angle,” urges Dr Bekedam.
“Low- and low-middle-income countries will be able to recoup the costs of generic DAAs in the form of reduced health care expenditure within less than one decade. This is a win-win situation,” says lead author Rakesh Aggarwal, MD, DM, at SGPGIMS, a WHO Collaborating Center on Viral Hepatitis.
