Good news for mild chronic hepatitis C sufferers as the UK's cost-effectiveness body, the National Institute for Health and Clinical Excellence, this week gave its backing to the use of Roche's Pegasys (peginterferon alfa) in combination with the gold-standard ribavirin on the country's National Health Service.
The move opens up a huge door for Roche as current practice means only patients with moderate or severe symptoms tend to receive treatment; between 200,000 and 500,000 people in the UK are estimated to have been infected with the hepatitis C virus - which can lead to liver injury - but less than 50,000 have actually been diagnosed and a pitiful 7,000 are receiving any therapy.
The new decision states that patients with mild chronic hepatitis be offered treatment with Pegasys plus ribavirin, or with Pegasys alone if ribavirin is not tolerated. And it passes the brunt of the decision onto the patient, stating that they should make the choice about whether to start treatment immediately or to wait until the disease has reached a moderate stage, but only after consultation with the clinician.
Although NICE failed to give the thumbs up to using the Pegasys combo in the under-18s or in liver transplant patients, it believes the additional cost of therapy will be more than offset by the potential of early drug use to delay disease progression, perhaps even preventing the need for a liver transplant at a later stage. NICE estimates an additional 3,500 patients will choose to have treatment, at a cost to the NHS of £25 million a year.
While charities were clearly delighted with the news, Charles Gore, Chief Executive of the Hepatitis C Trust, said the policy needed to be disseminated on a local level.
In an audit conducted on behalf of the All Party Parliamentary Group, The Hepatitis C Trust found that only 21 of the 305 primary care trusts in England have allocated significant additional resources in 2006 to treat patients with hepatitis C. “PCTs must take responsibility now to ensure that adequate services and funding are put in place to meet the increased demand for treatment - only with their full support can today's decision have any real impact on patients' lives,” he added.