Gastroenterologists Would Prescribe Sovaldi plus Daclatasvir plus Ribavirin to 60 Percent of Their Genotype-3 Patients, According to Findings from Decision Resources Group
BURLINGTON, Mass., April 1, 2014 /PRNewswire/ -- Decision Resources Group finds that surveyed gastroenterologists in the United States and Europe agree that the percentage of hepatitis C virus (HCV) genotype-3 infected patients with cirrhosis of the liver achieving a sustained virologic response (SVR) is one of the attributes that most influences their prescribing decisions. Clinical data and interviewed experts indicate that interferon-free regimens containing Gilead's Sovaldi (sofosbuvir) and Bristol-Myers Squibb's NS5A inhibitor daclatasvir have convenience and efficacy advantages over currently available regimens for HCV genotype-3 infections. However, competition from other NS5A inhibitors, such as Gilead's GS-5816, may constrain uptake of daclatasvir.
Other key findings from the DecisionBase report entitled Hepatitis C Virus Genotype 3: What Untapped Opportunities Remain for Treatment of Genotype-3 Infections:
- Payer receptivity to new HCV genotype-3 therapies: Almost half of surveyed U.S. managed care organization pharmacy directors would not reimburse a new HCV genotype-3 therapy offering a 6-week duration if priced at $100,000 per course, with a notable share citing price and insufficient clinical benefit as the reasons. This suggests that, assuming comparable efficacy, payers are unwilling to accept a premium for a shorter course of therapy.
- The importance of cost in treatment decisions for HCV genotype-3 infections: Conjoint analysis of drug attributes influencing prescribing behavior revealed that surveyed gastroenterologists perceive the cost of treatment as important as SVR rate in treatment decisions for HCV genotype-3 infected patients. This suggests that the cost of sofosbuvir plus ribavirin is a key barrier to prescribing and that physicians and payers will favor a lower-cost alternative with comparable efficacy and safety.
- Estimated prescribing of the sofosbuvir and daclatasvir combination: Surveyed U.S. gastroenterologists indicated that they would prescribe sofosbuvir and daclatasvir plus ribavirin to 60 percent of their HCV genotype-3 patients.
Comments from Decision Resources Group Analyst Seamus Levine-Wilkinson, Ph.D.:
- "Gilead's interim phase two data for their pangenotypic interferon- and ribavirin-free combination of Sovaldi and the NS5A inhibitor GS-5816 indicates that up to 100 percent of genotype-3 infected patients achieved SVR4. If these impressive results are confirmed in planned phase three studies, likely including evaluation of a coformulated sofosbuvir and GS-5816 one-pill, once-daily regimen, then this combination will provide a highly effective, safe, pangenotypic, and convenient single-tablet regimen for HCV infections. In other words, this could be one pill to rule them all."
- "Cost of HCV therapies is a serious concern among both payers and physicians. Given the high price for a 24-week course of Sovaldi, the new standard of care for HCV genotype-3 infections, it is likely that payers and physicians will be very skeptical of any new HCV genotype-3 therapy priced at a premium to Sovaldi. Conversely, a drug developer that is able to offer a lower-cost interferon- and ribavirin-free regimen for HCV genotype-3 that achieves high SVR rates, will be very well positioned to compete in this market segment."
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