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Indian Hepatitis C generics greatly bring down costs

Hepatitis C is a potentially deadly virus that can remain asymptomatic until severe damage has been done to the liver. There are an estimated 9 million people affected by the hepatitis C virus (HCV) in India, with 70 million affected worldwide. A recent study has provided information about the efficiency of Indian generic medications in combating the disease.

Could Indian generics provide a cheaper means of treating hepatitis C?

While HCV is often asymptomatic, it does on occasion show symptoms. Complications in diagnosis arise due to the similarity of these symptoms to many other conditions and illnesses, such as an acute bout of flu like symptoms, fatigue and general feelings of sickness. Many who are infected with HCV are drug users, due to this many symptoms associated with the illness such as lethargy can be mistaken as side effects of drug usage.. If left untreated severe damage can be caused to the liver, such as liver cirrhosis (a build up of scar tissue) which can eventually lead to liver failure.

The study, published in PLOS ONE discusses directly acting antivirals (DAAs) such as sofosbuvir (Sovaldi) and the hugely beneficial effect they have had in the treatment process of HCV. However, these DAAs often come at a very high cost, making them all but unavailable in many countries.

The contrast between the costs of the medications is extreme. In the US, a full course of brand name DAAs will cost around $65,000 USD. This price is still considered cost effective because the consequences of untreated disease are so severe. This kind of cost however, is out of the price range of many even in wealthy countries. In developing nations the usage of DAAs has lagged far behind and so HCV is left untreated.

The Indian generic versions are a fraction of this cost, a full course costing around $300 USD (it is worth noting that before this study, few investigations have been performed regarding the cost effectiveness and so their efficiency by comparison to the confirmed branded treatments was unknown). Due to a lack of data on their cost effectiveness these generic DAAs have not reached as many patients as they potentially could. This new study has finally produced medical data on the generics, potentially opening the way for state funding.

The results of the meta analysis of cost effectiveness and life years gained compared to no treatment were far more positive than expected. It was performed by investigators from Sanjay Gandhi Postgraduate Institute of Medical Sciences in Lucknow, India, collaborating with the World Health Organization. Using a mathematical model they compared the outcomes of generic DAA treatment with those of no DAA treatment based on profiles of 30 hypothetical patients with symptoms common to Indian patients with HCV infection.

The study found that in addition to increasing life expectancy by 8 years compared to those who were not medicated, the treatment is of such a low cost that the cost of treatment would be paid back between a 5 to 10 year period. The implications of which are, the costs to the patient are overall reduced over this period by addressing the disease swiftly, as opposed to paying for medication addressing both the disease and potential damage caused to the body years after the infection.

The low cost coupled with the reduction in future treatment costs associated with the disease has led to the generic DAAs to be declared as an ideal candidate for HCV treatment in low to middle income countries. Lead author of the study Dr. Rakesh Aggarwal commented:

“If these countries spend money on HCV treatment today, they will recoup it in the form of reduced health care expenditure within less than one decade. There is hardly any other health care intervention with such good return. Our results should show political leaders in those countries that they have a wonderful opportunity to make a difference for their constituents.”

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