Tag Archives: Hepatitis C virus

Hepatitis C drug delayed by NHS due to high cost

One in three people infected with hepatitis C will develop liver cirrhosis and some will get cancer. Photograph: Bsip/UIG via Getty Images

One in three people infected with hepatitis C will develop liver cirrhosis and some will get cancer. Photograph: Bsip/UIG via Getty Images

The NHS is to delay the introduction of a highly expensive drug that can save the lives of people infected with the hepatitis C virus. The move by NHS England is unprecedented, because the NHS rationing body, Nice (the National Institute for Health and Care Excellence) has approved the drug. Nice says sofosbuvir is cost-effective, because it is a cure for people who would otherwise run up huge NHS bills.

One in three people infected with hepatitis C will develop liver cirrhosis and some will get cancer. A liver transplant costs more than £50,000.

But NHS England appears to be balking at the bill for the drug, which would hit £1bn for every 20,000 people treated. Approximately 160,000 people in England alone are infected with hepatitis C, although fewer than half are aware of it.

Sofosbuvir has been hailed internationally as a breakthrough, but there is global concern over the very high cost of a drug that can save lives. Campaigners are pressing for lower prices, from the US – where it costs $1,000 a pill – to India, in a fight which they liken to that over drugs against another virus: HIV, which causes Aids. On Wednesday, they celebrated a decision by the Indian authorities not to allow a patent application for sofosbuvir by Gilead, the manufacturer, which means Indian companies may be able to make cheap copies for the developing world.

The price offered by Gilead in the UK is almost £35,000 for a 12-week course. Many patients will need a 24-week course, costing £70,000. In its final draft guidance on sofosbuvir, Nice said it was allowing NHS England to postpone implementation for four months, until the end of July instead the beginning of April. NHS England failed to comment.

Charles Gore, chief executive of the Hepatitis C Trust, said he was very concerned about the delay. Nice had allowed NHS England to make a decision based on affordability rather than cost-effectiveness. “It feels to me as if a whole new criterion has been invented by the backdoor,” he said. If the NHS could delay using a new drug by four months, it could also delay by six months or a year – or it could decide on the basis of its cash-strapped budget to use it one year but not the next.

“It is undoubtedly a high cost,” said Gore. “The unfortunate thing is there are an awful lot of people who need it. We’re talking about potentially hundreds of thousands of people. That becomes a massive budget-buster.”

NHS England has introduced a scheme to pay for the treatment of people who are very ill – many of them on liver transplant waiting lists. In April, it announced an £18.7m fund to pay for 500 patients with acute liver failure.

But Mark Thursz, professor of hepatology at Imperial College London and chair of the Hepatitis C Coalition, said there were others who needed treatment as soon as possible. “The delay is unprecedented,” he said. “What worries me about it is that if you have got advanced liver disease with hepatitis C, you could progress at any stage to the point where it is very difficult or impossible to reverse the situation or have any improvement. Opportunities are being missed by any delay.”

About 10,000 to 15,000 of people with hepatitis C infection in the UK have cirrhosis, he said. Around 5,000 have advanced disease and need treatment soon if they are not to suffer long-term damage.

Hepatitis C is spread by contact with infected blood. Some people live with it unknowingly for years having injected drugs in their youth, while some got it from blood transplants before screening for the virus was introduced. It is also thought to be spread by sharing razors or toothbrushes with those infected.

There are older drugs but the treatment lasts up to four years and has serious side-effects, including depression. Sofosbuvir is a once-daily pill, taken with one or two other drugs for 12 or 24 weeks

Stelios Karagiannoglou, Gilead’s general manager, UK and Ireland, said the company was pleased with the Nice decision. But he added: “We are disappointed that the majority of patients will not gain access to this important medicine until later this year.” He called on NHS England to commit to a scheme from April offering early treatment for people with cirrhosis.

Story via The Guardian

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Victims of contaminated NHS blood launch legal case


Three men who contracted hepatitis C from contaminated imported blood have begun a legal case in the UK to challenge the compensation scheme.

They say it is unfair under disability discrimination because other patients in the same scandal have more favourable terms.

A new parliamentary report says around 7,500 patients were infected by imported blood products.

The government said it was considering improvements to the support system.

The three men, who are pursuing the case anonymously, claim the compensation scheme discriminates against them for having the hepatitis C virus, by paying them far less than patients with HIV receive.

Just under 6,000 people have been identified as having contracted hepatitis C and more than 1,500 others the virus which can lead to Aids, according to the report by the All-Party Parliamentary Group (APPG) on Haemophilia and Contaminated Blood.

More than 2,000 patients are thought to have died as a result of what has been called “the worst treatment disaster in the history of the NHS”.

“We believe it is clearly unlawful that one group of sufferers of a serious virus are treated differently.” – Rosa CurlingLawyer, Leigh Day

The report says thousands of people in the UK – many of them with haemophilia – were infected when they were treated with blood products imported from the US in the 1970s and 80s.

An independent inquiry report six years ago described the events as a “horrific human tragedy”.

Lawyer Rosa Curling, from the law firm Leigh Day, is representing the three men.

She told BBC News: “Both HIV and hepatitis C virus are life-threatening, life-long chronic conditions.

“These viruses both sadly have serious implications for those who carry them and, in a proportion of cases, will lead to the death of the patient.

“We believe it is clearly unlawful that one group of sufferers of a serious virus, contracted through the same NHS disaster, are treated differently on account of their disability.”

Successive governments have set up five different trusts to pay compensation to patients who were treated with the blood products.

Leigh Day says the discrimination goes beyond the lifetime of the victims, because dependents of those who die after contracting hepatitis C also receive lower payments.

The law firm has sent a detailed legal letter, asking the Health Secretary Jeremy Hunt to take action to correct the anomalies between the schemes.

The “letter before action” asks for a response within 14 days, before the possibility of further legal proceedings in the High Court through judicial review.

Ms Curling added: “Our clients wish to avoid litigation if this is possible.

“We want the chance to sit down with Jeremy Hunt, and obtain a commitment from him urgently to put things right.”

NHS treatment ‘devastated lives’

The APPG report highlights how most people with hepatitis C receive no ongoing payments, and they feel as though they have to beg for discretionary payments.

It recommends that payments to people infected through contaminated blood are at a level which lifts them out of poverty.

The issue is the subject of a backbench Commons debate today.

Liz Carroll, Chief Executive of the Haemophilia Society, said: “We speak to families affected by this scandal on a daily basis. Many are living in poverty, unable to pay everyday bills.

“Some live in damp conditions due to household repairs waiting to be funded, going back several years.

“Others are unable to prove they were infected by NHS treatment as their medical records are missing.

“NHS treatment devastated many lives. Now is the time to right this wrong and enable them to live with dignity.”

The Penrose Inquiry in Scotland is due to report imminently – this will be the first statutory inquiry looking into government culpability for the problem.

A Department of Health spokesperson said: “This is a very serious issue and we are looking at possible improvements to the system of providing support to those affected.

“For legal reasons we are unable to comment further on this specific case.”

Story via BBC

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Pill Targeting Hepatitis C Launched

A new pill that directly targets hepatitis C for the first time has been launched in the UK.

A new pill that directly targets hepatitis C for the first time has been launched in the UK

In clinical trials, adding Victrelis to standard therapy increased the number of chronic patients freed from the virus up to threefold.

Hepatitis C is a blood-to-blood infection that attacks the liver. It is commonly spread by injecting drug users sharing needles, body piercing and tattoos.

The virus can also be transmitted by blood transfusions, but donor screening has prevented this happening in the UK since 1991. Sexual transmission is extremely uncommon.

The infection is known as the “silent epidemic” because it may take decades to produce any symptoms. Ultimately, the virus can cause serious liver damage or liver cancer.

Around 216,000 people in the UK are believed to be chronically infected with hepatitis C but many do not know it.

Until now, licensed treatments have relied on boosting the immune system to fight the infection.

Victrelis, one of a class of drugs called protease inhibitors, is different because it attacks the virus directly.

Charles Gore, chief executive of the the Hepatitis C Trust charity, said: “Hepatitis C is called the silent epidemic because hundreds of thousands of people carry the virus yet the great majority have no idea they are infected.

“It can take decades for symptoms of hepatitis C to emerge and when they do, damage to the liver may have already occurred. Raising awareness of the condition and getting more people tested are critical, but we also need effective treatments once it is diagnosed.”

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Via Belfast Telegraph