NICE approves new treatments for hepatitis C

NICE recommends Daklinza (daclatasvir) for use in some patients with the most difficult-to-treat type of chronic hepatitis C.

Commenting on the NICE recommendation, Anna Maria Geretti, Professor of Virology and Infectious Diseases, University of Liverpool, said: “It is a challenge to treat patients with hepatitis C virus infection, including the significant number of patients with genotype 3, whose condition tends to progress rapidly. In the past there have been limited treatment options available and therefore this decision is an important milestone. Daclatasvir in combination with other agents represents a much needed oral treatment regimen that has been shown to cure the infection in the majority of patients, and we have already seen positive results in the real-life setting in patients with advanced disease.”

HCV genotype 3 is associated with accelerated progression to end-stage liver disease, making treatment time critical. Genotype 3 is associated with increased incidence of hepatocellular carcinoma in cirrhotic patients, and more rapid progression to fibrosis compared with other genotypes, leading to increased mortality. Deaths from HCV have nearly quadrupled between 1996 and 2012 in England.

Up until recently treatment options for genotype 3 patients have been limited. Standard of care has been up to 48 weeks of interferon-based therapy which could be associated with a number of debilitating side effects throughout the body. Daclatasvir in combination with other treatments, has been generally well tolerated and has been shown to clear the infection in most of these patients after 12 or 24 weeks of therapy. It is currently one of only two all oral treatment regimens recommended in EU guidelines by The European Association for the Study of the Liver (EASL) for patients with genotype 3.

HCV is usually asymptomatic in the early years, which contributes to the fact that as many as 50% of people living with the disease may be undiagnosed. Furthermore, 60–70% of all those infected will go on to develop chronic liver disease.

In 2012, healthcare costs associated with the condition were estimated at £82.7 million in the UK. A study has found that by 2035 this figure is projected to rise to £115 million, if current treatment levels remain the same.

Johanna Mercier, General Manager of BMS UK & Ireland commented: “Before now hepatitis C patients have had limited treatment options and we are delighted that NICE has taken the decision to recommend daclatasvir-based regimens. BMS and clinicians alike have seen the positive impact this treatment has had among some patients in the UK to date and it is therefore good news that it will now be available to a wider group of people who are in much need of new treatment options.”