Worldwide treatment of hepatitis C could be within sight at the right cost

There are an estimated 185 million people infected with the hepatitis C virus worldwide and 160,000 in Britain. Currently there is no vaccine and, if left untreated, infection can lead to cirrhosis and liver cancer, causing up to 500,000 related deaths globally per year. Hepatitis C is particularly problematic in low to middle income countries; for example 12 million people are infected in Egypt.

A new and effective generation of direct-acting antiviral drugs (DAAs) has been developed to treat hepatitis C (see sidebar). However, at present these drugs are highly expensive. A 12-week course of the new drug sofosbuvir in the US is priced at as much as $84,000 per person and £55,440 in the UK. The NHS has recently delayed introduction of sofosbuvir due to its high price.

The treatment of HIV provides a precedent for cutting the costs of drugs on a large scale to make them available across the world. The drugs that have been rolled out worldwide for HIV are similar in chemical structure and mechanisms to the new generation of hepatitis C drugs. Therefore, the researchers believe that it is feasible that global hepatitis C treatment could be achieved if the manufacturing and monitoring costs of those drugs were minimised in the same way as was done with HIV which involved the lifting of patents to allow drugs to made by generic manufacturers.

In the study, published in Hepatology, the researchers used HIV drugs as a framework for the analysis to explore what would be possible if drugs were produced at a large scale with the removal of patents to enable generic versions of these DAAs to be manufactured.  This is feasible since India has recently filed a patent opposition to sofosbuvir and, if successful, this would mean the patent would no longer restrict the manufacture of the drug and generic versions could be made by a range of manufacturers. 

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