New hepatitis C drug exciting -- but expensive
A new drug has just been approved by Health Canada for hepatitis C that might put the word "cure" within reach of some patients -- something unheard of with current treatments. But the drug comes with a hefty price tag and it's unclear who will be paying for it.
Hepatitis C is a liver disease that can range in severity from a mild illness that lasts just a few weeks, to a serious, lifelong disease. The condition often goes unnoticed for years until it causes the liver to become inflamed and prevents it from working properly, sometimes leading to liver cancer.
Some 300,000 Canadians have hep C, as does actress Pamela Anderson and singer Steven Tyler. It's transmitted through blood, usually from contaminated needles.
Until now, the main treatment has been a double drug regimen called peginterferon alpha and ribaviron-based therapy (peg/riba). The meds are designed to boost the immune system to fight off the virus but both tend to be ineffective in many patients. They can also cause serious side effects that force many patients to stop treatment.
But a new generation of hepatitis drugs is on the horizon. Earlier this week, a new medication called Victrelis (boceprevir) was approved in Canada, designed to be taken in combination with the current hep C therapies.
Victrelis is one of about 40 new hepatitis drugs that will be coming out in the coming months and years, drugs that some say will usher in a new era of treatment for hepatitis C.
When taken with peg/riba, studies show Victrelis can significantly increase a patient's chance of clearing the hepatitis virus from the body.
"It is going to boost the cure rate in patients who have never been treated before from about 45 per cent up to about 65 per cent. And this is a big, big improvement," says Dr. Morris Sherman, a hepatologist with the Canadian Liver Foundation and a professor of medicine at University of Toronto.
For patients who have not yet been treated or have not responded to previous treatment, he says this drug offers an exciting development that brings them hope for a cure.
What makes Victrelis different is that it is able to attack the virus itself. It is a part of a class of drugs called protease inhibitors, which work by binding to the virus and preventing it from multiplying.
Chris Robinson hopes the drug will help him. The 51-year-old was finally diagnosed with hep C a year ago but the disease has already attacked and damaged his liver. Now, he needs a liver transplant to survive.
But first doctors have to try to clear the virus from his body so that it doesn't attack his new liver, and they hope the new drug will do the trick.
"According to my doctor, this is going to cure me," he says. "I am hoping this gets the virus completely out of my system. That's the idea behind it."
He says the drug is "a godsend."
"Who wouldn't want it? I enjoy this life, I don't want to roll over and let this beat me," he says.
But the hope the drug brings comes with a hefty price: about $1,050 a week on top of the $400 a week for the standard treatments. Some patients can be cured in an little as 28 weeks of therapy, but other patients might need to stay on the drug much longer.
Robinson, who is too sick to work, doesn't have a drug plan.
"I don't know how I will pay for it. I will cross that bridge when I get to it," he says.
So far, the provinces haven't said whether they will be covering the medication under provincial health plans. Victrelis is yet another drug to add to the list of ever more costly medications that provinces are being asked to cover.
Infectious diseases expert Dr. Neil Rau admits it's a dilemma.
"The great thing here is that we have a treatment that increases the chance of response, or cure, but if one third of all people with hep C in Canada -- 100,000 people -- got that treatment, that would be 100,000 times $50,000 per person. That's a lot of money," he notes.
Robinson says he's holding out hope that his provincial government will help him. He says he was willing to gamble because he has an 11-year-old and wants to live to see him grow up.
"This is for life or death. Without this, I am dead," he says. http://bit.ly/p2qf7K