MAYWOOD, IL – Hepatitis C drugs cure more than 90 percent of patients, but they can cost more than $ 50,000 per patient.
Findings from a new study could lead to significant cost savings. Preliminary data from the study, led by a theoretical modeling researcher at Loyola University, Chicago Stritch School of Medicine and Loyola Medicine, found that in 50% of patients, the standard 12-week treatment regimen could be reduced to just six weeks without compromising efficacy.
"There is the potential to save up to 20% of the cost of hepatitis C drugs," said Loyola researcher Dr. Harel Dahari, co-author of the study with Ohad Etzion, MD of the Soroka University Medical Center in Israel. Senior author is Amir Shlomai, MD, PhD, of Beilinson Hospital in Israel.
The study was presented on November 12 at the annual meeting of the American Association for the Study of Liver Disease in San Francisco.
Dr. Dahari is co-director of the Experimental and Theoretical Modeling Program (PETM) in the Loyola Medicine Hepatology Division and the Loyola Chicago Stritch School of Medicine. Two other Loyola authors are Susan Uprichard, PhD, Co-Director of PETM and Associate Professor in the Microbiology and Immunology Department and Scott Cotler, MD, Head of the Hepatology Division, Medicine Loyola, and a professor in the Loyola University Department of Medicine Chicago Stritch Medicine School.
Hepatitis C is an infection caused by a virus spread by contaminated blood. This can lead to liver damage, liver failure and liver cancer. Approximately 70 million people around the world, including about three million in the United States, are infected with chronic hepatitis C.
An oral class of drugs, called DAA, revolutionized the treatment of hepatitis C. In more than 90% of patients, the drugs eliminate the virus and heal the patient with minimal side effects. But high costs limit access and represent a substantial financial burden for Medicare, Medicaid and private insurers.
The treatment is currently standardized to be given for a certain amount of time, usually 12 weeks, rather than being adapted to the individual patient, Dr. Cotler said.
In the new study, the researchers used a customized medical technique called response-based modeling therapy to reduce treatment time when possible. After the patients were treated for several weeks, the researchers measured the amount of hepatitis C viruses low. They used mathematical modeling to estimate how long it will take to completely eliminate the virus.
The study included 22 patients so far. Mathematical modeling predicted that treatment could be reduced to 10 weeks per patient (five per cent of patients), eight weeks in eight patients (36 per cent), and six weeks in two patients (nine per cent). The other 11 patients (50%) had to be treated for the 12-week standard.
Twenty-one patients remained free of viruses. The only patient who relapsed had the most difficult form of hepatitis C virus, known as genotype 3.
The demonstrative pilot study of the concept has shown that the use of response-guided therapy to reduce treatment time is feasible. In order to validate the results, an ample multicenter study is taking place in Israel.
Dr. Dahari said that in addition to reducing costs, shorter treatment regimes would make it easier to treat hepatitis C patients who have limited health insurance benefits.
The study was conducted with doctors David Yardeni, Dr. Anat Nevo-Shor, Dr. Daniela Munteanu and Dr. Naim Abufreha from the Department of Gastroenterology and Liver Disease, Medical Center of Soroka University, Beesheba, Israel; Assaf Issachar, MD, Dr. Michal Cohen-Naftaly, Orly Sneh Arbib and MD Marius Braun, Liver Institute, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel; and Dr. Orna Mor, Central Virology Laboratory, Ministry of Health, Sheba Medical Center, Israel.
The study is titled "Response-guided therapy with DAA shortens the duration of treatment in 50 percent of patients treated with HCV.
The study was partly supported by Clalit, a health services body in Israel and the US National Health Institute.
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