Use of the generic versions of directly-acting antiviral (DAA) drugs that are available in India to treat hepatitis C virus (HCV) infection can increase lifespan while reducing lifetime health care costs, says a study.
Compared with no DAA treatment, use of the generic drugs in HCV-infected Indian patients would increase life expectancy by more than eight years while reducing lifetime health care costs by more than $1,300 (Rs. 116,442) per person, said the study published in the journal PLOS ONE.
“More than 9 million people are infected with HCV in India, and more than 70 million worldwide,” said Jagpreet Chhatwal of the Institute for Technology Assessment at Massachusetts General Hospital (MGH), senior and corresponding author of the paper.
“These persons are at risk of developing serious conditions such as cirrhosis and liver cancer, which can be fatal. However, only a fraction of them have been treated with these drugs so far,” Chhatwal said.
First introduced in 2011, DAAs such as sofosbuvir (Sovaldi) and ledipasvir (which is combined with sofosbuvir in Harvoni) have proven to be remarkably successful in the battle against HCV infection, with cure rates exceeding 95%.
In developed countries, treatment with DAAs is very expensive — reaching nearly $65,000 in the US — although it meets standards for cost effectiveness.
In those countries the advent of these drugs has drastically changed the landscape of HCV infection. But other countries have lagged behind in their use.
Through agreements with the pharmaceutical companies that developed these drugs, generic drug manufacturers in India are now able to produce versions that cost as little as $300 for the entire duration of treatment, the researchers said.
The research team — including investigators from Sanjay Gandhi Postgraduate Institute of Medical Sciences in Lucknow, India, and the World Health Organization – used a mathematical model to compare the outcomes of DAA treatment with those of no DAA treatment based on profiles of 30 hypothetical patients with characteristics typical of Indian patients with HCV infection.
The researchers found that costs for generic hepatitis C drugs available in India would be paid back in five to 10 years.
Even though there was wide variation in the factors — such as patient age, disease stage, and viral genotype — input to the model, results always indicated that generic DAA treatment reduced lifetime costs.
“Our hypothesis was that treatment would be cost saving, given the low drug costs in India. However, we were pleasantly surprised to find that the full payback was achieved so soon after treatment,” said Chhatwal, who also serves as Assistant Professor of Radiology at Harvard Medical School.