Low cost Indian generic HCV antivirals help expand life expectancy, cut costs for patients: Report

Indian generic makers - credited for significantly bringing down cost of HIV-AIDS treatment by supplying low cost anti-retroviral drugs - have repeated the history, but this time with direct antiviral drugs (DAA) to treat Hepatitis-C virus (HCV) infections.

The use of generic versions of DAA drugs, available in India, to treat Hepatitis-C virus (HCV) infection have increased lifespan of the patients while reducing lifetime health care costs, finds a new study by an international team of researchers from Sanjay Gandhi Postgraduate Institute of Medical Sciences in Lucknow, Massachusetts General Hospital Institute for Technology Assessment, Boston and the World Health Organization.

The report titled ‘Cost-effectiveness of hepatitis-C treatment using generic direct-acting antivirals available in India’ is published in open-access journal PLOS ONE.

HCV infects more than 70 million people worldwide and between 6–11 million in India

Chronic HCV infection is the leading cause for liver cirrhosis and liver cancers. If left untreated, HCV infection also leads to substantial economic burden.

In India, HCV infection was estimated to be responsible for 59,000 deaths in the year 2015.

Here are the findings of the study:

Increased life expectancy

Compared with no DAA treatment, use of the generic drugs in HCV-infected Indian patients increased the life expectancy by more than eight years while reducing lifetime health care costs by more than USD 1,300 per person treated, the report said.

Payback for the upfront costs of DAA drugs would be achieved in an overall average of less than 10 years - under 5 years for patients at advanced stages of the disease and almost 12 years, if treatment begins at earlier stages.

Indian generic antivirals

Introduced in 2011, the DAAs such as sofosbuvir, ledipasvir and daclatasvir have changed the paradigm of treating HCV infections with cure rates exceeding 95 percent.

In developed and middle income countries, the DAAs are expensive, for instance reaching nearly USD 65,000 in the US limiting the accessibility to the patients.

US-based biotechnology company Gilead, which was under pressure from advocacy groups and patent litigants in India, ended up signing licensed agreements with thirteen Indian drug manufacturers that allow production and distribution of new Hepatitis-C drugs in 101 developing countries.

Through this agreement, the Indian generic drug manufacturers are now able to produce versions of the drug that cost as little as USD 300 for the entire duration of treatment.

But the absence of data on the cost effectiveness of these drugs in India and low budgets for HCV treatment have meant that only a small proportion of people needing these drugs have received them, the report said.

Given the improved patient outcomes and also result in cost-savings in a fairly short time-frame, the report advises the government to make HCV treatment a priority.

“HCV treatment should be a priority for health planners of this country, and other countries where low-cost DAAs are available, not only from the public health viewpoint, but also from the economic perspective,” the report added.