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NICE recommends Victrelis and Incivo for hepatitis C

Drugs marketed by MSD and Janssen to be available on NHS in England and Wales

Janssen's Incivo and MSD's Victrelis have been recommended for reimbursement by the NHS when used in the treatment of hepatitis C.

The National Institute for Health and Clinical Excellence (NICE), which serves as a cost watchdog for England and Wales, has published guidance stating that both treatments should be available for the treatment of genotype 1 chronic hepatitis C, when used in combination with peginterferon alfa and ribavirin.

Professor Carole Longson, health technology evaluationcentre director at NICE, said: “The significant improvement in sustained virological response rates seen with boceprevir or telaprevir plus peginterferon alfa and ribavirin compared with peginterferon alfa and ribavirin alone represents a major benefit for people with genotype 1 chronic hepatitis C.”

Genotype 1 is the most common subtype of hepatitis C in England and Wales affecting around half of the estimated 255,000 people with hepatitis in the region.

It is also the most resistant to treatment, with Longson describing how patients have declined treatment with peginterferon alfa andribavirin alone as the chance for a sustained response was too low to compensate for side effects such as nausea, insomnia, depression and diarrhoea.

Both Incivo and Victrelis work the same way by inhibiting the activity of the NS3/4A serine protease, an enzyme that is essential for viral replication.

NICE said that the serine protease may be partially responsible for the ability of the hepatitis C virus to evade clearance by the host immune system.

The guidance was welcomed by patient group, the Hepatitis C Trust. The organisation's chief executive Charles Gore said: "People living with genotype-1 hepatitis C who have perhaps been delaying starting treatment, or who have lost hope after their previous treatment had failed them, can now be offered cost effective treatments that offer them a much better chance of clearing the virus than ever before.

“This is really great news and I look forward to direct acting anti-virals being made available to all patients on the NHS as soon as possible."

26th April 2012

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