The All Wales Medicines Strategy Group (AWMSG) has recommended Daklinza® (daclatasvir) for the treatment of adult patients with chronic hepatitis C virus (HCV) infection. The recommendation is specifically for patients with advanced liver disease, for whom treatment options can be limited. Daclatasvir is used in combination with other agents to treat adult patients with chronic HCV genotypes 1, 3 and 4 (which include most of the cases seen in Wales). This decision could enable some of the most ‘at-risk’ patients in Wales with chronic HCV to access a new, first-in-class treatment which has been shown, when used with other agents, to clear the viral infection in most of these patients after 12 or 24 weeks of therapy.
Commenting on the AWMSG recommendation, Dr. Brendan Healy, Consultant in Microbiology and Infectious Diseases at the University Hospital of Wales, said:
Today’s decision marks an important milestone for patients in Wales with chronic hepatitis C. People living with this virus could go on to develop liver damage and liver cancer. Clearing the virus in these patients is not only good for their health but also for the wider community as it reduces the risk of onward transmission. Daclatasvir is an important addition to our armamentarium against this disease and will help us to treat patients.
Hepatitis C is a preventable and treatable blood-borne viral disease which, if left untreated, can lead to potentially fatal cirrhosis or cancer of the liver. Recent estimates indicate that approximately 12,000 people have chronic HCV in Wales.
“We are at a real turning point in the fight against the virus,” said Charles Gore, Chief Executive of The Hepatitis C Trust. “We must not forget that hepatitis C can cause liver damage without the sufferer even knowing they are carrying the virus. Having access to new tolerable options that can help to treat these patients is really important and we welcome this progressive recommendation by the AWMSG.”
Chronic hepatitis C is usually asymptomatic in the early years, which contributes to the fact that as many as 50% of people living with the disease may be undiagnosed. Furthermore, 60% of all those infected will go on to develop some level of damage to their liver. Specifically in cirrhotic patients with HCV, it is predicted that up to 8% will develop liver cancer, 1-2% will develop liver failure and liver transplantation will be required in a further 5-10%. Less than a sixth of the HCV infected population in Wales is currently being monitored or treated by specialist services.
Commenting on the recommendation of the AWMSG, Johanna Mercier, General Manager, Bristol-Myers Squibb, UK and Ireland said:
Hepatitis C patients with advanced liver disease have limited treatment options and we are therefore delighted that the AWMSG has taken the decision to recommend daclatasvir-based regimens.