New drugs could eliminate need for liver transplants in some patients
Published Saturday, June 4, 2016 10:25PM EDT
A handful of Canadian patients with hepatitis C have been removed from liver transplant waiting lists thanks to expensive new drug treatments that have stopped the potentially deadly disease from spreading.
Around 20 patients have been removed from Canada’s liver transplant waiting lists, according to surveys collected by Dr. Paul Marotta, a liver specialist at London Health Sciences Centre.
Doctors say the phenomenon is due to new hepatitis C-fighting medications such as Harvoni and Sovaldi, which hit the market a few years ago and appear to destroy the disease.
“It’s very amazing, not only for the individuals who are afflicted with this condition but also for physicians like myself around the world who are just witnessing this amazing miracle, as it were, in the field of liver transplantations,” Dr. Marotta told CTV News.
He says that fewer procedures and medications could mean significant potential savings per patient.
“We would be saving several hundreds of thousands of dollars and typically in the role of millions of dollars per patient if they are not requiring a liver transplant,” Marotta said.
Hundreds of patients across Canada are currently waiting for liver transplants, and about 40 per cent of those patients have hepatitis C. To make matters worse, the health care system is seeing a crippling shortage of organs available for transplant.
Fred Burton, 58, was on a waiting list for a transplant when he was prescribed Harvoni, an antiviral combination drug designed to block the hepatitis C virus from replicating.
Within a few months, Burton’s liver was healthy. His name was subsequently deleted from the waiting list.
“I went from being on a transplant list to being a new person in 12 weeks. It’s like a second chance,” Burton said.
Dr. Marotta says that sort of dramatic turnaround marks a major step forward in treating hep C and could lead to fewer Canadian patients dying while they wait for a life-saving transplant.
But at $50,000 per patient, some doctors are unsure whether the pricey medication is worth it.
An estimated 250,000 Canadians are affected by hepatitis C, a blood-borne viral disease capable of destroying the liver. According to some estimates, treating every Canadian patient with the innovative drugs could cost more than $10 billion.
Other doctors say it will take more time to determine all the benefits versus the budgetary considerations.
“If it really is working to this degree, it may be, but we need to have bigger numbers and a more careful analysis to see just how much of a dividend we’re getting from paying this money up front for these drugs,” said Dr. Neil Rau, medical director of Infection Prevention and Control at Halton Health Services.
The pills have opened up debate around the world about how much a government should be willing to pay for effective but costly medical treatment.
Germany and France both invested around $2 billion in the treatment. Global leaders discussed the innovative drug treatment at the recent G7 summit in Japan, with efforts to negotiate lower prices for the drugs from its makers.
Sovaldi was launched in 2013, and its first version has reportedly been effective for 90 per cent of patients with hepatitis C. A similar drug, Harvoni, is made for people with genotype 1 hepatitis C virus. Both drugs are manufactured by American biopharmaceutical company Gilead Sciences and have been approved by Health Canada.
According to the World Health Organization, hepatitis C is responsible for 500,000 deaths each year. Between 130 million to 150 million people worldwide are estimated to be living with hepatitis C.
With a report by CTV News medical specialist Avis Favaro and producer Elizabeth St. Philip