Hepatitis C Treatments Increasingly Available in Developing World, but Still Quite Costly in the US

New hepatitis C treatments made more available through competition from generic medicines and other access strategies have been given to more than one million patients in as many as 13 low-and middle-income countries, according to a new report from the World Health Organization (WHO).

Published by WHO, The Global Report on Access to Hepatitis C Treatment: Focus on Overcoming Barriers shows “how political will, civil society advocacy and pricing negotiations” help address the disease burden of hepatitis C, a virus that contributes to nearly 700,000 deaths each year worldwide, states a release issued by WHO. In Egypt, which has among the highest prevalence rate of hepatitis C, the cost of treatment has dropped in two years from $900 to $200.

"Licensing agreements and local production in some countries have gone a long way to make these treatments more affordable," Suzanne Hill, PhD, WHO’s director for essential medicines and health products, stated in the release. "But there are still huge differences between what countries are paying. Some middle-income countries, which bear the largest burden of hepatitis C, are still paying very high prices. WHO is working on new pricing models for these, and other expensive medicines, in order to increase access to all essential medicines in all countries.”

In the past three years, approval of a handful direct-acting antiviral treatments for the hepatitis C virus has brought attention to the new drugs, which have shown high cure rates in clinical trials. The same drugs, however have also stirred debate over how much drug companies charge for them and “widespread fears that their high price would put them out of reach” for many in need of the drugs, according to the release.

Perhaps the highest-profile and earliest to market was Gilead Sciences’ drug Sovaldi, which hit the market in the US at a total price of about $85,000 for a full treatment. Other hepatitis C drugs have since followed with similar price tags in the US, but in other countries more affordable options have surfaced.

The WHO supported a series of access strategies that it says led to improved availability in several low-to middle-income countries including Argentina, Brazil, Egypt, Georgia, Indonesia, Morocco, Nigeria, Pakistan, Philippines, Romania, Rwanda, Thailand and Ukraine. Those efforts include competition from generic medicines through licensing agreements, local production and price negotiations, the release states.

"Maximizing access to lifesaving hepatitis C treatment is a priority for WHO," Dr Gottfried Hirnschall, director of WHO's Department of HIV and Global Hepatitis Programme, stated in the release. "It is encouraging to see countries starting to make important progress. However, access still remains beyond the reach for most people."

There are still various countries, including in the European Union, where high drug costs have led to treatment rationing, according to the WHO release.

"Today's report on access, prices, patents and registration of hepatitis C medicines will help create the much needed market transparency which should support country efforts to increase access to DAAs," Hirnschall stated in the release. "We hope countries will update their hepatitis treatment guidelines, work to remove barriers to access, and make these medicines available promptly for everyone in need."

The WHO report was based in part on information gathered from surveys of selected countries and pharmaceutical companies, questionnaires completed by representatives of ministries of health, pharmaceutical companies and generic DAA-producing companies, and interviews with representatives of selected nongovernmental organizations.

Related Coverage:

A New Direction in the Search for a Hepatitis C Vaccine

Study Underway on Irish Women Seemingly Immune to Hepatitis C

Eradication of Hepatitis C Dependent on Drug Users' Access to Treatment