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Genetic markers being used to target oral hepatitis C drug

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Genetic markers being used to target new oral hepatitis C drug

A person’s genetic makeup will be used to target a new funded oral treatment for hepatitis C patients from 1 September.

PHARMAC will begin funding boceprevir (Victrelis) from 1 September 2013 for certain patients with the chronic liver infection. Boceprevir will be funded when used as a triple therapy in combination with pegylated interferon with ribavirin.

PHARMAC Medical Director Dr Peter Moodie says many hepatitis C patients do not respond well to current treatments, but that this could improve with the addition of boceprevir.

“Clinical evidence shows that, given the genetic characteristics of a patient, a simple genetic test can fairly accurately predict how they might respond to treatment,” says Dr Moodie.

“There is a group who we know respond poorly to current treatment. They are the ones we think will benefit most from the addition of this new treatment.”

About 25-35% of patients with certain genes showed a sustained response to the currently available treatment of pegylated interferon and ribavirin. By adding boceprevir to the treatment of these patients, the response rate increases to 70–75%.

As well as adding greater effectiveness to available treatments, Dr Moodie says boceprevir is the first funded oral treatment specifically for hepatitis C.

Patients will be genetically tested to determine whether they qualify for boceprevir (in combination with pegylated interferon and ribavirin) as a first-line treatment.

Boceprevir will also be funded for people who have tried but not responded completely to a course of pegylated interferon and ribavirin.

Dr Moodie says though many people live with hepatitis C without ever knowing it, the infection can cause significant health issues including hepatocellular carcinoma, liver failure, which may require a liver transplant.

Pharmacological treatment aims to reduce the likelihood of these transplants being required. In total, PHARMAC expects around 300 patients to start triple therapy in the next year.

In addition to funding boceprevir, PHARMAC has negotiated a price reduction for the Pegasys brand of pegylated interferon with ribavirin. Together, the funding of these hepatitis C treatments will cost $17.8 million over five years, with some of this cost being refunded through confidential rebates negotiated with both suppliers.


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