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Baby Boomer Screening, Game-Changing Drugs Change the Landscape for Hepatitis C Treatment


AJMC Panel Touts Shift from 'Chronic' to 'Cured' as FDA Gives Breakthrough Status to BMS All-Oral Combo Regimen


Baby Boomer Screening, Game-Changing Drugs Change the Landscape for Hepatitis C Treatment

AJMC Panel Touts Shift from ‘Chronic’ to ‘Cured’ as FDA Gives Breakthrough Status to BMS All-Oral Combo Regimen

PLAINSBORO, N.J. — The recommendation that all baby boomers be screened for hepatitis C, coming amid a tidal wave of new therapies that move patients from a chronic condition to a cure, is changing the landscape in treatment of hepatitis C.

A baffling and debilitating liver disease, hepatitis C gained steam in the early 1980s, before blood products were routinely screened for its presence. The American Journal of Managed Care recently convened a panel of experts, led by co-editor in-chief Dr. A. Mark Fendrick of the University of Michigan and a practicing physician, who discussed the importance of last year’s recommendations of the U.S. Preventive Services Task Force (USPSTF) that all Americans born between 1946 and 1964 be screened for hepatitis C, or HCV. An estimated 3.2 million people have the virus, but the vast majority are unaware they have it; screening would allow candidates for treatment to rid themselves of the disease early before complications become difficult and expensive to treat. To hear the discussion, click here.

Yesterday, Bristol Myers-Squibb announced that the US Food and Drug Administration had granted breakthrough therapy status to its all-oral regimen of daclatasvir and asunaprevir for patients with genotype 1b. It’s the latest piece of good news that the nation is closer to taming a disease that has wreaked havoc among victims who often contracted it unwittingly, whether they were patients who needed blood transfusions in an earlier generation or nurses who were stuck with a needle on the job.

Fendrick led a lively discussion with Dr. Steven Miller, chief medical officer of Express Scripts; Dr. Nezam H. Afdahl, associate professor of medicine, Harvard School of Medicine and chief of hepatology, Beth Israel Deaconess Medical Center; and Dr. David Winston, section head of gastroenterology & hepatology, Cigna HealthCare of Arizona.

Given the age of the targeted screening population, there are enormous health and financial implications of the USPSTF action, to which Fendrick and his fellow panelists alluded. With hepatitis C treatment moving from “chronic care” to “cure,” screening baby boomers before most of them retire means those found to be carrying the virus can not only avoid becoming more ill, but the cost of treatment will largely be borne by commercial insurers, not Medicare.

Among the points of the discussion were:

  • Up to 1 million people need treatment, and the USPSTF recommendation could allow them to get care much earlier, avoiding poor health outcomes and higher costs.
  • While panelists agreed that new oral therapies, which currently include sofosbuvir and simeprevir, can move treatment from the specialists to primary care physicians -- Dr. Afdahl said treatment can often be “one pill, once a day” -- Dr. Miller said the initial care plan should be developed by a hepatologist.
  • Dr. Winston said there is a great need for education among primary care physicians, including the fact that the USPSTF recommendation means the test will be free.
  • Recommendations for widespread screenings may cause alarm for commercial plans due to the potential for soaring costs. But Dr. Afdahl said that the cost of treatment to cure HCV, which may be possible in 90 to 94 percent of cases with new therapies, must be weighed against the cost of caring for what was once an expensive, long-term chronic condition.

CONTACT: Nicole Beagin or Mary Caffrey (609) 716-7777 x. 131 or 144

nbeagin@ajmc.com or mcaffrey@ajmc.com


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