The National Institute for Health and Care Excellence has issued new draft guidelines expanding its endorsement of Janssen’s Olysio (simeprevir) and Gilead’s Sovaldi (sofosbuvir) to treat certain patients with hepatitis C on the National Health Service in England.

In final draft guidance, the cost regulator has recommended Olysio as a treatment option for genotype 1, the most common form of HCV accounting for 46% of diagnoses, as previously.

But in a change to its earlier position, the Institute is now also supporting the drug’s use in patients with the less less prevalent genotype 4 HCV, which accounts for around 4% of total cases.

For treating genotype 1 HCV, the incremental cost-effective ratios for Olysio plus peginterferon alfa and ribavirin compared with peginterferon alfa and ribavirin alone was between £14,200 and £9,800 per QALY, NICE said. And in all scenarios for genotype 4 HCV, the ICERs for Olysio/peginterferon alfa and ribavirin compared with peginterferon alfa and ribavirin remained below £20,000 per QALY gained. 

Sovaldi's reach extended

Similarly, final draft guidance published for Gilead’s Sovaldi has also been extended to include more people with chronic HCV for whom the drug can be considered a treatment option.

In addition to genotype 1, the new draft guidance now also recommends the drug as an option for some people with genotypes 4, 5 and 6 chronic disease, offering more patients the chance of having a shorter interferon-based regimen - associated with a number of often unpleasant side-effects such as chronic fatigue - or in some cases none at all.

Final guidelines for both drugs are expected next month.