Quality and Efficacy Concerns with Generics in Treatment of Hepatitis C with Directly Acting Antivirals

Abstract

Treating hepatitis C has never been so convenient after the advent of Directly Acting Antivirals (DAA). Convenience is at both ends; for the doctors to prescribe and for patients to comply due to all oral therapy with few adverse effects. Many are already in market, these include, Sofosbuvir, Declastavir & Velpastavir while many others are in pipeline. The SVR success rates with these newer drugs is approaching 99% and they are also showing improvement in fibrosis1,2. Cost of innovative brands of DAAs is very high. According to one study Quality-Adjusted Life Years (QALY) with innovator sofosbuvir for short therapy resulted in expense of $24,000 as compared to no treatment3 . Pakistan being a poor country with low per capita income, health and innovator brand medicines are not in approach of average patient. With availability of generics there is up to 70% reduction in cost of treatment and they come into the affordability range of most of the patients4-7 .