As companies queued up to present piles of data on the new wave of hepatitis C drugs at the Liver Meeting in Washington DC, new research has revealed that 90% of doctors in the USA are holding off treating patients until more efficacious and tolerable new therapies become available.

A study has been conducted by healthcare market pollster Research Partnership which reveals that, with over nine in ten doctors taking a wait-and-see stance, 51% of HCV patients eligible for care in the USA are not currently undergoing treatment. It notes that after two decades of "limited therapies offering low success rates and harsh side effects", last year's launches of Vertex' Incivek (telaprevir) and Merck & Co's Victrelis (boceprevir) "have been welcomed because they are more effective".

However, despite stellar revenues initially, sales of the two treatments are falling because they still need to be given with interferon, which causes the strongest side effects. Research Partnership notes that "the race is on for a number of pharmaceutical companies to release new interferon-free regimens, which are currently in the late stages of development and due to be released within the next 6-12 months".

Waiting for interferon-free regimens

The survey found that 62% of patients currently being 'warehoused' will only start treatment once an interferon-free regimen becomes available. Almost 80% of doctors (68 were polled) stated that an interferon-free therapy is the most important feature likely to increase uptake amongst untreated patients.

At the end of October, Gilead Sciences' NS5B polymerase inhibitor sofosbuvir and Johnson & Johnson and Medivir's simeprevir were unanimously endorsed by a US Food and Drug Administration advisory committee. These compounds are being investigated in combination with other drugs in interferon-free late-stage trials as are offerings from a number of firms, notably AbbVie, Merck & Co, Boehringer Ingelheim and Bristol-Myers Squibb; the latter has just filed an all-oral combination (daclatasvir, a NS5A inhibitor and the protease inhibitor asunaprevir) in Japan, which B-MS notes is the world’s first interferon- and ribavirin-free treatment regimen for the disease.