丙型肝炎药物可能花费$ 84,000。这个新的一个可能会一样好 -

StephenW

Hepatitis C Drugs Can Cost $84,000. This New One May Be Just As Good—But Cost $300

By Sy Mukherjee April 12, 2018

Striking advances in hepatitis C drug development over the past five years have made the infectious, liver-wasting viral disease a curable one—if you can afford the drugs.

Made by companies like Gilead, AbbVie, Merck, and others, drugs that treat the disease are listed at tens of thousands of dollars in the U.S. But a nonprofit is making its own hepatitis C combination medication that it says is just as effective as those created by for-profit drug giants. And it could cost just $300 for 12 weeks of treatment in poor nations like Malaysia.

The hep C treatment is being developed by the Drugs for Neglected Diseases Initiative (DNDi) in collaboration with Egyptian drug maker Pharco Pharmaceuticals. It combines the generic chemical form of Gilead’s brand name hepatitis C treatment Sovaldi (sofosbuvir) and Pharco’s experimental ravidasvir. Drugs like Sovaldi and its successor Harvoni come with list prices upwards of $84,000 in the U.S. (patients don’t pay that much following rebates and patient assistance programs, but they’re still quite expensive); Gilead, AbbVie, and others have special patient access programs in lower-income countries that slashes those prices significantly for the world’s poor.

But those programs aren’t available in every nation and, for some, may not go far enough. A more expansively available, cheap option like DNDi’s treatment could theoretically help get millions of more people on treatment—there are about 2.7 million to 3.9 million Americans with chronic hepatitis C, according to the Centers for Disease Control (CDC), but more than 71 million people worldwide are living with the virus. DNDi’s planned pricing would represent a nearly 100% discount to what’s currently available in Malaysia, for instance.

Still, a $300 hepatitis C cure isn’t reality quite yet. While the new mid-stage study results from DNDi were impressive (they showed cure rates of 96% to 97% even for the sickest patients and those with liver scarring), more late-stage trials will be necessary before the drug is available on a large scale in the developing world.

U.S. drug makers are also starting to get diminishing returns from selling their hepatitis C treatments right here in America. So many companies have developed such increasingly effective medicines, such as those that treat more hep C strains with far shorter treatment regimens, that Gilead—a pioneer in the field with Sovaldi and Harvoni—is projecting $3.5 billion to $4 billion in U.S. sales from these kinds of drugs in 2018, a dramatic drop from nearly $13 billion in 2015. AbbVie’s rival Mavyret, for instance, carries a nearly 60% list price discount per month compared to Gilead’s drugs and requires one less month of treatment.

StephenW

丙型肝炎药物可能花费$ 84,000。这个新的一个可能会一样好 - 但成本300美元

由Sy Mukherjee于2018年4月12日发布

过去五年中丙肝药物的发展取得了惊人的进展，如果您负担得起这些药物，那么这种传染性肝耗竭性病毒性疾病就成为可以治愈的病毒性疾病。

由Gilead，AbbVie，Merck等公司制造的治疗这种疾病的药物在美国上市时价值数万美元。但是，一家非营利组织正在制造自己的丙型肝炎联合药物，据说它与所创造的疗效一样有效由营利性药物巨头。在马来西亚这样的贫穷国家，治疗12周可能花费300美元。

hep C治疗正在由被忽视疾病药物倡议组织（DNDi）与埃及制药商Pharco Pharmaceuticals合作开发。它结合了Gilead品牌丙型肝炎治疗Sovaldi（sofosbuvir）和Pharco实验性ravidasvir的通用化学形式。像Sovaldi及其继任者Harvoni这样的药物在美国的价格高达84,000美元（在退税和患者援助计划之后，患者付不起那么多，但他们仍然相当昂贵）; Gilead，AbbVie和其他人在低收入国家有专门的患者接入项目，这些项目为全球贫困人口大大降低了这些价格。

但是这些计划在每个国家都不可用，而且对于一些国家来说，这些计划可能还不够。根据美国疾病控制中心（CDC）的数据，一种更广泛可用，价格便宜的选择，如DNDi的治疗理论上可以帮助获得数百万人接受治疗 - 约有270万至390万美国人患有慢性丙型肝炎，但超过71全世界有百万人患有这种病毒。例如，DNDi的计划价格将比马来西亚目前的价格低100％。

不过，300美元的丙型肝炎治疗并不现实。虽然来自DNDi的新的中期研究结果令人印象深刻（即使对于最严重的患者和具有肝瘢痕形成的患者，其治愈率也达到96％至97％），但在药物可用之前更晚期的试验是必要的在发展中国家大规模。

美国制药商也开始因在美国销售丙型肝炎治疗而获得报酬递减。许多公司已经开发出了这种越来越有效的药物，例如那些治疗更短的治疗方案的治疗更多的丙型肝炎病毒的药物，作为Sovaldi和Harvoni领域的先驱的Gilead，预计这些药物在美国的销售额将达到35亿美元至40亿美元2018年的药物种类从2015年的近130亿美元大幅下降。例如，AbbVie的竞争对手Mavyret与Gilead的药物相比，每月的价格折扣接近60％，并且需要一个月的治疗。