The UK is bottom of the league table in every aspect of preventing and treating patients with hepatitis C, according to a new report commissioned by the Hepatitis C Trust, which calculates the virus costs the country’s National Health Service could reach a staggering £8 billion within 30 years.
The news is another slight on the ability of the UK’s National Institute for Health and Clinical Excellence – a cost-effectiveness body – to get approved treatments to patients. In the UK just 1%-2% people infected with the disease receive NICE-approved treatments that could prevent liver cirrhosis and cancer, says the report. In stark contrast, patients in France are six-12 times more likely to be given effective treatment, cutting the prevalence of chronic liver disease.
Charles Gore, Chief Executive of The Hepatitis C Trust says: “The Government needs to make hepatitis C a priority. We have a dreadfully poor track record at diagnosing the disease. Over 400,000 people in the UK with the virus are completely unaware they have been infected.” In addition, only one in seven infected people in the UK has been tested for the virus, meaning that patients are only being identified when they have progressed to late stage liver disease. Untreated hepatitis C is set to cost the NHS £156 million in 2006 alone.
And a recent report from Datamonitor estimates that, globally, the number of hepatitis C patients could increase three-fold by 2014, principally because of a rise in diagnosis. The WHO estimates that the average worldwide prevalence of HCV infection is around 3% or 170-200 million people. HCV infection is asymptomatic for 90% of its history, which suggests a large number of individuals are unaware of their infection and are not receiving treatment, says Datamonitor infectious diseases lead analyst, Dr John Savopoulos.
Roche and Schering-Plough manufacture the big-selling treatments Pegasys (peg-interferon 2a) and PEG-Intron (peg-interferon 2b), which are used in combination with the antiviral ribavirin and can eradicate the virus in around 50% of cases. The three drugs make up the bulk of an estimated $2 billion global market for HCV treatments, which is predicted to grow to around $4 billion in 2013, says Datamonitor, which estimates there are currently around 22 compounds within clinical development falling into four main classes: the immunomodulators, interferons, small molecule antivirals and host enzyme inhibitors. Importantly, Novartis has established strong relationships with Idenix (NM283, valopicitabine) and Anadsys (Isatoribine, other immune enhancers); Pfizer acquired Idun for the caspase inhibitor IDUN-6556; Roche spent around $150m investing in Pharmasett’s HCV compounds (PS-6130); Schering-Plough moved closer to Migenix’ Celgosivir (MX-3253) and Gilead has recently entered the fray with GS-9132.
- Meanwhile, the European Liver Patients’ Association has delivered a petition to the European Health Commissioner, Markos Kyprianou, demanding prevention and support programmes be established for the 12 million people with viral hepatitis across Europe.