The Golden Age of Interferon-Free HCV Therapies | Physician & Payer Forum | US | 2015

How Will Healthcare Reform and Payer-Led Cost-Containment Strategies Impact U.S. Prescribing?

The market opportunity for hepatitis C virus (HCV) features a large prevalent population, a significant proportion of which is at risk of advancing liver disease. The primary goal of HCV treatment is to completely eliminate the virus from the patient’s body and thereby reduce or halt the progression of liver fibrosis, preventing further complications, such as cirrhosis and hepatocellular carcinoma. Previous treatment strategies for HCV included the prescribing of suboptimal interferon (IFN)-based therapies (Roche’s Pegasys or Merck’s PegIntron), which were associated with significant tolerability issues, efficacy limitations, and long treatment durations. The HCV treatment landscape in the United States has been dramatically altered by the approval of novel antiviral therapies, including Gilead’s Sovaldi (sofosbuvir) and Harvoni (sofosbuvir/ledipasvir), Janssen’s Olysio (simeprevir), and AbbVie’s Viekira Pak (paritaprevir/ombitasvir/ritonavir plus dasabuvir), ushering in the era of IFN-free therapy for HCV. These therapies are typically highly efficacious and well tolerated, making it difficult for pharmaceutical companies to differentiate their products from competitors. An important battleground in the future will be duration of treatment, where genotype-1 market leader Harvoni holds the potential to reduce treatment duration to 8 weeks from the current standard of 12-24 weeks for genotype-1 patients. In addition, pan-genotypic activity and elimination of ribavirin (Roche’s Copegus; Merck’s Rebetol; generics) from treatment regimens represent key unmet needs in the HCV space. Marketers of HCV therapies also face an increasingly competitive landscape and maneuver to secure formulary inclusion and preferred status through exclusive deals, rebates, and discounts. U.S. payers and prescribers are challenged with incorporating these highly desirable but costly new therapies into medical practice.

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