Quantcast
Get breaking news alerts via email

Click here to manage your alerts
Utah doctor helps craft attack plan for hepatitis C
Health reform » Utah liver specialist on national panel guiding doctors in using revolutionary treatments.
First Published Feb 04 2014 05:55 pm • Last Updated Feb 04 2014 10:50 pm

A revolution in treatment for the 3 million people in the U.S. chronically infected with liver-damaging hepatitis C has driven doctors to take unusual steps to speed patient access to emerging and expensive therapies.

Hepatitis C is the leading cause of liver cancer and liver transplants. The current treatment — a mix of injectable medicines and a pill — can take months and cause debilitating, flulike symptoms.

At a glance

About hepatitis C

Rates of hepatitis C, a chronic viral infection, are lower in Utah than in other states. But it remains a leading cause of cirrhosis and liver transplants. It is one of several hepatitis viruses, including A, B, D and E, but considered to be the most serious.

The current standard of care involves weekly injections of interferon and an oral antiviral drug. Treatment therapies can last several months and have serious side effects.

New therapies interfere with the viruses’ ability to replicate, have far fewer side effects, promise to shorten treatment and significantly improve cure rates.

Sources: Utah Department of Health and liver specialists.

Join the Discussion
Post a Comment

But two drugs approved in late 2013 by the Food and Drug Administration (FDA), and another soon to be considered for approval, are expected to act faster, be easier on patients and bump the cure rate from about 70 percent to 90 percent, said Utah liver specialist Michael Charlton, medical director of Intermountain Medical Center’s Liver Transplant Program.

"When I say cure I mean it never comes back," he said. "The virus is gone unless you get re-infected. … By 2015 there’s every indication there will be a single pill that will cure almost everyone."

Charlton, formerly of the Mayo Clinic, was among 27 experts nationally who, anticipating FDA approval of the new drugs, rushed to publish preliminary treatment guidelines for clinicians.

The guidelines, sponsored by the Infectious Diseases Society of America and the American Association for the Study of Liver Diseases, don’t carry the same weight as those vetted over time by medical journals.

But they may help convince insurers to cover the new treatments and give nonspecialists greater comfort in prescribing them, said Charlton.

"We were worried about people having access to treatment," he said, citing a federal survey showing only 50 percent of those diagnosed with chronic hepatitis C get treatment. "There’s a shortage of liver specialists in this country and treatment is complicated enough that there’s concern about getting it right."

Publicly available online at www.HCVguidelines.org, the guidelines could also prove a useful educational tool for patients, he said.

They don’t touch on cost or dictate which patients are candidates for the new drugs. Those details will be added later, Charlton said.


story continues below
story continues below

Because only 15 percent of hepatitis C patients get cirrhosis of the liver and become candidates for a transplant, "you could make a case for a wait-and-see approach with some patients," said Charlton. "I’m not advocating that, but I recognize it’s a balancing act. We need to at least think about the cost-benefit of these things."

Patient groups have accused Gilead Sciences Inc., maker of sofosbuvir, and Janssen Therapeutics, maker of simeprevir, for overpricing their medicines, which Charlton said average $150,000 for a full regimen.

He, too, wishes they were more affordable for patients, but stressed he’s grateful they were developed.

"We tend to see drug companies as Darth Vader-ish … but if you take away advances developed by private industry it’s a very different landscape. We’d be looking at a 12 percent cure rate for hepatitis C," he said.

Charlton believes debates over the appropriateness of treatments are best left to medical experts armed with data. "You really need an independent panel to come together to put forward recommendations free of conflicts."

SelectHealth, the insurance arm of Charlton’s employer Intermountain Healthcare, is still weighing whether to cover the new hepatitis C drugs. But he says, "I met with them and … I’m confident they will accept these guidelines."

kstewart@sltrib.com

Twiter: @KStewart4Trib



Copyright 2014 The Salt Lake Tribune. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Top Reader Comments Read All Comments Post a Comment
Click here to read all comments   Click here to post a comment


About Reader Comments


Reader comments on sltrib.com are the opinions of the writer, not The Salt Lake Tribune. We will delete comments containing obscenities, personal attacks and inappropriate or offensive remarks. Flagrant or repeat violators will be banned. If you see an objectionable comment, please alert us by clicking the arrow on the upper right side of the comment and selecting "Flag comment as inappropriate". If you've recently registered with Disqus or aren't seeing your comments immediately, you may need to verify your email address. To do so, visit disqus.com/account.
See more about comments here.
Staying Connected
Videos
Jobs
Contests and Promotions
  • Search Obituaries
  • Place an Obituary

  • Search Cars
  • Search Homes
  • Search Jobs
  • Search Marketplace
  • Search Legal Notices

  • Other Services
  • Advertise With Us
  • Subscribe to the Newspaper
  • Access your e-Edition
  • Frequently Asked Questions
  • Contact a newsroom staff member
  • Access the Trib Archives
  • Privacy Policy
  • Missing your paper? Need to place your paper on vacation hold? For this and any other subscription related needs, click here or call 801.204.6100.