Hepatitis C: Drug Prices, Lack of Testing are Challenges

The tougher challenge, discussed at a closing day session led by the World Health Organization is finding a way to step up testing.  “Treating patients is not difficult; finding them is,” Peck said, "You can't treat what you haven't found."

Despite the wealth of choices physicians have in finding drugs to treat hepatitis C infection, two challenges remain in eradicating the disease—drug price and lack of global screening for the virus.
“Price is solvable,” said Markus Peck, MD, the outgoing secretary of the European Society for the Study of the Liver (EASL) interviewed at the International Liver Congress in Vienna, Austria.
“Pharma has to make some money on these drugs,” Peck said, since their cost of developing them has been high, “but as there is more competition we are quite sure the price will go down.”

There are currently 7 different classifications of drugs that fight hepatitis C. Those are nucleoside and nucleotide NS5B polymerase inhibitors, nucleoside analogs, protease inhibitors, nucleoside analogs, pegylated interferon, NS5A inhibitors, non-nucleoside NS5B inhibitors, and combination drugs that draw on two or more of those classes.

Not counting interferon, there are also 7 drugs or drug combos approved by the US Food and Drug Administration and another 14 in phase 3 drug trials.

 - See more at: http://www.hcplive.com/conference-coverage/easl-2015/Hepatitis-C-Price-Lack-of-Testing-are-Challenges#sthash.ggeNy7xf.dpuf

Risk-based testing in primary care missed most patients with HCV

Risk-based testing for hepatitis C virus in the primary care setting may have missed more than 80% of patients with hepatitis C virus antibodies, according to researchers from the CDC.

“This may be due in part to the difficulty in capturing complete patient risk history (eg, injection drug use) in [electronic medical records (EMR)] to support the implementation of comprehensive risk-based HCV testing algorithms,” the researchers wrote in Clinical Infectious Diseases. “HCV-infected persons who are not aware of their status cannot receive further clinical evaluation, antiviral treatment, and are unlikely to benefit from preventive services or secondary prevention recommendations (eg, reduction in alcohol use and other lifestyle changes) aimed at limiting disease progression and reducing liver-related morbidity and mortality.”

The researchers evaluated EMR data from patients enrolled in the Birth Cohort Evaluation to Advance Screening and Testing for HCV (BEST-C) study to estimate how many patients with HCV remained unidentified after risk-based testing in the primary care setting. They also quantified the prevalence of HCV antibody positivity among primary care patients and determined predictors of HCV infection.

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