Study: Shortening Hepatitis C Treatment Feasible in Half of Patients

New research suggests that hepatitis C virus (HCV) treatments can be shortened in half of patients receiving them without compromising efficacy, potentially leading to significant cost savings.
An estimated 70 million individuals worldwide are chronically infected with HCV. Although the disease is curable, direct acting anti-viral (DAA) drugs used to treat HCV can be costly, ranging between $40,000 and $100,000. Despite advancements in treating HCV, cost and access remain a significant barrier for many patients.
In the study, which was presented at the annual meeting of the American Association for the Study of Liver Disease in San Francisco, California, the researchers used a personalized medicine technique called modeling-based response-guided therapy to reduce treatment times when possible. Following a few weeks of treatment with DAA drugs, the researchers measured how much HCV levels had decreased and used mathematical modeling to estimate how long it would take to eliminate the virus.
Of the 22 patients included in the study, the modeling estimated that treatment could be shortened to 10 weeks in 1 patient, 8 weeks in 8 patients, and 6 weeks in 9 patients. Fifty percent of patients needed to receive the standard 12-week regimen. Overall, 21 patients remained virus-free, and the only patient who relapsed had the most difficult-to-treat form of the virus.
Insurers may restrict access to these medications in some cases due to high cost, making it difficult for patients to access their treatment. A recent study published in Open Forum Infectious Diseases indicated that the number of patients denied coverage from private and public insurers remains high. An analysis of data found that among 9025 patients from 45 states who were publicly insured, 35.5% were denied coverage. Additionally, private insurers denied coverage for 52.4% of patients.
According to co-first study author Harel Dahari, PhD, the findings indicate potential savings of up to 20% of the cost of HCV drugs if treatments could be tailored to the individual patients. In addition to reducing costs, shorter treatments regimens would make it easier for patients with HCV who have limited health insurance benefits, he noted.
Overall, the study’s findings showed that using response-guided therapy to reduce treatment times can be used while maintaining the efficacy of DAA drugs, the researchers concluded. A large multicenter trial is underway to further validate the results. 
Hepatitis C treatment can be shortened in 50 percent of patients, study finds [news release]. Loyola University Health System. Accessed November 12, 2018.

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