From 2013 onward, we have seen a tremendous success in Hepatitis C treatment. Speaking in drug discovery, Hep C is the single most innovative treatment area in recent years. In February 2016, a new player joined the Hepatitis C therapeutic area – Merck Co. with the introduction of a new drug Zepatier (elbasvir and grazoprevir).
Zepatier is the latest drug for curing chronic Hepatitis C. The medicine consisting of the drug molecules, elbasvir and grazoprevir, was awarded an FDA approval for Hepatitis C treatment. Clinical trials have shown that 12- or 16-week Zepatier regimen cures more than 94% of patients which makes this elbasvir and grazoprevir Hepatitis C regimen side by side to all recently discovered Hepatitis C cures. Here is a short list of the newly available medication Hepatitis C patients can choose from:
- Sovaldi (sofosbuvir) by Gilead Sciences
- Harvoni (sofosbuvir and ledipasvir) by Gilead Sciences
- Olysio (simeprevir) by Janssen
- Daklinza (daclatasvir) by Bristol-Myers Squibb
- Viekira Pak (ombitasvir, paritaprevir, ritonavir and dasabuvir) by AbbVie
- Zepatier (elbasvir and grazoprevir) by Merck Co.
Zepatier (elbasvir and grazoprevir) – Who is it for?
When it comes down to chronic Hepatitis C, patients can have 1 out of 6 possible genotypes. Zepatier, an elbasvir and grazoprevir regimen, has been approved by the FDA to treat genotypes 1 and 4. This is very fortunate because most of Hepatitis C patients have one of these two genotypes.
Zepatier is also adult-only medicine. Namely, it was registered to be safe for patients over 18 years old. A very great majority of Hepatitis C patients are older than 40 years; hence the newly developed medication by Merck Co. can be used to treat almost every Hepatitis C patient.
Zepatier Cure Rate
The most important thing about Hepatitis C drugs is the cure rate. We have seen science come a long way, leaving being 50% success rate of interferon and replacing it with 95% cure rate of Harvoni, for example.
Zepatier cure rate is 94%. This makes is a very efficient medicine that can contest with other Hepatitis C drugs on the market very well.
Zepatier Hepatitis C treatment regimen
In the past, patients were used to sticking themselves with interferon injections. The discovery of a valid one pill per day regimen was welcomed by Hepatitis C patients. Zepatier comes in a form of pills containing elbasvir and grazoprevir. The regimen is very simple and straight forward: 1 pill of Zepatier per day will drive Hepatitis C away in 12- or 16-weeks, depending on Hepatitis C genotype.
Zepatier and Ribavirin
For some patients, ribavirin pills have to be included in Zepatier treatment regimen. This largely depends on the state of patient's liver and genotype of the virus; however, Zepatier with ribavirin is not a new approach. The first new line Hepatitis C drug, Sovaldi, also uses an addition of ribavirin to the regimen for some patients. Especially problematic is genotype 2 treatment – Combination of Zepatier and ribavirin, however, has been proven efficient to treat even the harshest and resilient Hepatitis C virus infections.
Zepatier side effects
Every drug has side effects and Zepatier, being a life-saving medication, is no exception. Luckily, the adverse effects of elbasvir and grazoprevir regimen are very mild and comparable to side effects of other Hepatitis C cures. Here is a short list of the most common side effects patients treated with Zepatier can expect:
- Anemia (decrease in number of red blood cells)
- Stomach pain
- Allergic reactions (rashes, irritation)
Approximately 5% of patients in Zepatier clinical study by Merck Co. had experience one or more such side effects on Zepatier. Taking together Zepatier and ribavirin combo can cause additional side effects such as joint pain and shortness of breath.
Zepatier also comes with a special warning regarding the more severe side effects of elbasvir and grazoprevir combo. It was suggested based on clinical studies that as the result of function of Zepatier, liver enzymes can be elevated for more than 5 times. This can be very problematic for the metabolism of Zepatier, ribavirin and other medication patients take. Namely, the liver readily eliminates majority of therapeutic drugs in a normal manner. However, if this process is quickened because there are more than five times more liver enzymes, the effect of the drugs can be decreased. In short, it can mean that while you're on Zepatier, many other medications will have no effect on your body. This effect, however, was noticed in less than 1% of the Hepatitis C patients.
The cost of Hepatitis C treatments is notoriously high. With the invention of Sovaldi ($80,000 per treatment) and later Harvoni ($94,500 per treatment), the price standard is exceptionally high and ever since patients and medical professionals alike have been waiting for some much needed competition to drive down the prices of life-saving medicines. Here is where the cost of Zepatier comes in handy.
Zepatier cost is $54,600 per 12-week treatment, which is considerably lower than what Harvoni costs. Hopefully, this price will force other Hepatitis C drug producers such as Gilead and Abbvie to lower the prices of their medications. Nonetheless, it is easy to see why Zepatier price is lower – Merck is a late arrival in Hepatitis C treatment market and in order to be competitive with the more known drugs, has to decrease the cost of its elbasvir and grazoprevir treatment.
Drug producers reduce price of drugs by coupons and bonuses
Pharmaceutical marketing departments are working around the clock to bring Hepatitis C patients the deals they would readily take. It is very hard thing for an average US citizen to just go to local pharmacy and buy $94,500 worth of drugs, and he or she needs a little incentive (as if the drugs saving one's life is not enough). This is why Gilead and other companies try to reduce their Hepatitis C prices by introducing coupons and bonuses. For example, the Gilead co-pay programme knocks 25% off Harvoni. These kinds of marketing tricks have been proven to work but the ethical debate here is that it is all targeted at seducing Hepatitis C patients to buy their expensive drugs.
It is our hope that the effective Zepatier will in time prove to be both successful for Hepatitis C treatment and successful in driving down the costs of other Hepatitis C medications. In such a way, the would be more available to the patients who are in dire need of them.