Q&A: The new $84,000 hepatitis C drug


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What is hepatitis C?

It’s a long-term liver illness that can last for life, and the most severe cases could lead to cirrhosis or liver cancer. Anywhere between 75 percent and 85 percent of people who contract the virus develop a chronic condition. There is no vaccine that can prevent the disease, which now kills an estimated 15,000 people each year.

How many people have it?

About 3.2 million people have chronic hepatitis C in the United States, including one in every 33 baby boomers, according to the CDC. Between 130 million and 170 million people around the world carry the disease, according to estimates from the World Health Organization. However, an estimated 75 percent of infected people don't know they have hepatitis C.

How is it spread?

It’s most commonly spread by sharing needles or other equipment to inject drugs, according to the Centers for Disease Control and Prevention. However, it was also spread through blood transfusions and organ transplants before greater testing of the U.S. blood supply started in 1992. It can also be spread from an infected mother to a child during pregnancy, through personal care items carrying another person’s blood, and sexual contact with an infected person.

Who should get screened?

The CDC recommends current and past users of injectable drugs, people with abnormal liver tests or liver disease and people infected with HIV get tested for hepatitis C. The CDC has also recommended that people born between 1945 and 1965, who have a much higher prevalence of infection, get tested. Medicare, the government health plan for seniors, recently said it will pay for a single screening test for anyone born during those years, and it will cover screening tests for high-risk beneficiaries.

How was it previously treated?

Previous treatments weren’t nearly as effective as Sovaldi and other drugs now in the later stages of development. Hepatitis C was most commonly treated with a combination of daily drugs and weekly injections of interferon for anywhere between 24 and 48 weeks. Interferon potentially has especially nasty side effects, including flu-like symptoms, depression, fatigue and diarrhea. Previous treatments had only about a 50 percent cure rate.

Is $84,000 the final price of Sovaldi?

Not necessarily. Insurers have been trying to negotiate with the manufacturer, and U.S. government health programs receive a 23 percent discount. Sovaldi is cheaper in countries where the government sets drug prices, ranging from $900 in Egypt to $66,000 in Germany. And for some patients, Sovaldi has been paired with Johnson and Johnson’s Olysio, another new hepatitis C drug priced at $66,000 in the United States.

Jason Millman covers all things health policy, with a focus on Obamacare implementation. He previously covered health policy for Politico.
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