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Conventional medical treatment for controlling hepatitis C is extremely expensive, about $190,000 for the average patient, and not especially reliable. Even worse, side effects abound. A new drug, however, may give hepatitis C patients better quality life

Recently the US Food and Drug Administration approved a first of its kind medication to control the hepatitis C virus, sofosbuvir, which will be sold under the brand name Sovaldi. This new drug for the first time makes it possible to treat hepatitis C without any injections, and without the flu-like symptoms induced by interferon.

What's Different About Sovaldi?

Sovaldi is a new type of hepatitis C drug called an nucleotide analog inhibitor, or more precisely, a nucleotide analog reverse transcriptase inhibitor. The way the drug works is by inhibiting the action of an enzyme known as RNA polymerase. The hep C virus needs this enzyme to 
"write" the information from its DNA onto the molecule RNA so it can make the proteins it needs to reproduce. When the virus cannot reproduce or leave the cells it occupies, it eventually is destroyed by the immune system without triggering the massive inflammation that sometimes also destroys healthy liver tissue.

What's Better About Sovaldi?

Solvaldi is the first medication that makes it possible to treat hepatitis C medically without the use of interferon, a medication that "interferes" with the ability of the virus to multiply inside liver cells. Interferon is 60 to 80% effective when patients show up for their appointments to get intravenous injections of it, but about half of people who have hepatitis C either can't or won't take interferon because its side effects are so unpleasant. 

Treatment with Sovaldi, on the other hand, has been found to be up to 100% effective when Sovaldi is combined with another medication in a different class called an NS5A inhibitor. These drugs, which include the FDA approved drug daclatasvir, prevent the virus from making a protein it needs to replicate itself to maintain the infection inside the body. Sovaldi has to be given as part of a drug cocktail, a mixture of drugs, all taken in pill form, for this high response rate.

How Much Will Sovaldi Cost?

A week's supply of Sovaldi retails for approximately US $7,000. Hepatitis C patients who are infected with the genotypes (strains) 1 or 2 of the hep C virus need to take the drug for 12 weeks to achieve a sustained antiviral response, and hepatitis C patients who are infected with genotype 3 of the virus need to take the medication for 24 weeks for a sustained antiviral response. The cost of 12 weeks of treatment is $84,000, while the cost of 24 weeks of treatment is $168,000.

How Can Anybody Afford to Take Sovaldi?

Since Sovaldi is FDA-approved, it will be covered by health insurance plans as soon as January 1, 2014. But since Sovaldi is not a first-line treatment for hepatitis C (that is, the insurance company will want to make sure you absolutely cannot tolerate the much less expensive drug interferon before giving you any coverage for Sovaldi), there probably won't be a standard copay. Even with the best insurance coverage, Sovaldi will probably cost between $50 and $500 a month, or as much as $15,000 a month on any insurance plan "grandfathered" under the Affordable Care Act. That's why it's not a bad idea to look at other options for staying well.

Continue reading after recommendations

  • Tucker ME. Costs for Hepatitis C Treatment Skyrocket. Medscape News. 13 November 2013.
  • White DL, Ratziu V, El-Serag HB. Hepatitis C infection and risk of diabetes: a systematic review and metaanalysis. J Hepatol 2008. 49(5): 831–844.
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