Doctors Without Borders Secures Generic Hepatitis C Treatment

The international medical humanitarian organization Doctors Without Borders/M�decins Sans Fronti�res (MSF) announced it can now purchase generic hepatitis C medicines for as low as $1.40 per day, or $120 per 12-week treatment course, for two key medicines used to treat and cure this disease, sofosbuvir and daclatasvir.

This dramatic price reduction, which will benefit patients in countries where MSF can supply generic versions, illustrates the importance of generic options, which could, if expanded, help countries provide treatment for millions of people and improve public health by preventing the spread of this disease.

In the U.S., pharmaceutical corporation Gilead launched sofosbuvir at $1,000 per pill in 2013, and Bristol-Myers Squibb (BMS) launched daclatasvir at $750 per pill in 2015, leading to the original price tag of $147,000 for a person's 12-week combination treatment course. The corporations have also been charging exorbitant prices in many developing countries, paralyzing the launch of national treatment programs and causing treatment rationing in many countries around the world.

"What good is a breakthrough medicine that people cannot afford because pharmaceutical corporations are choosing to charge outrageous prices?" asked Jessica Burry, pharmacist for MSF's Access Campaign. "Pharmaceutical corporations price hepatitis C medicines far out of reach for people paying out of pocket around the world, and also for many governments struggling to provide treatment in the public sectors, but expanding access to generic versions means the prices can keep coming down."

In 2015, MSF started procuring sofosbuvir and daclatasvir from Gilead and BMS through their "access programs" at a price of $1,400 to $1,800 per 12-week treatment. Today, MSF pays a fraction of that at $120 using quality-assured generic manufacturers. In a presentation at the World Hepatitis Summit 2017, Dr. Andrew Hill, a pharmacologist and researcher at Liverpool University, announced findings that show a 12-week course of drugs to cure hepatitis C could be manufactured for even less at $50 per course.

Direct-acting antiviral medicines (DAAs) like sofosbuvir and daclatasvir represent a treatment breakthrough for people with hepatitis C, with cure rates of up to 95 percent, and with far fewer side effects than previous treatments. Yet access to DAAs has remained limited because pharmaceutical corporations charge unaffordable prices. By the end of 2016, three years after sofosbuvir was launched, only an estimated 2.1 million people globally had been treated with the medicines, leaving 69 million people still without access.

These high prices have also put a major strain on health systems in wealthy countries. Treatment is being rationed and given only to the people with the most advanced stages of the disease in countries such as Australia, Canada, Italy, the U.S., as well as developing countries because they can't afford to treat everyone. This is reminiscent of the early days of HIV treatment, said MSF.

"Almost two decades ago, MSF and others worked hard to get access to generics and bring down prices for HIV medicines," said Mickael Le Paih of MSF in Cambodia, where MSF treats people living with hepatitis C. "History is repeating itself with hepatitis C -- the medicines we need are again too expensive, but we are finding ways to make treatment affordable so that our patients can be cured."

MSF treats people with hepatitis C in 11 countries. Since 2015, MSF has provided DAA treatment to nearly 5,000 people with hepatitis C. Of those who have completed treatment to date, the overall cure rate is 94.9 percent.