Telaprevir-based triple therapy effective, but costly in incarcerated, HCV-infected patients

CHICAGO — Incarcerated hepatitis C virus genotype 1-infected patients achieved modest sustained virologic response after 12 weeks of telaprevir-based triple therapy that cost an average of $70,000 per patient, according to research presented at Digestive Disease Week 2014.

Researcher John P. Rice, MD, of the University of Wisconsin School of Medicine and Public Health, and colleagues conducted a pilot study of 36 incarcerated patients (34 men) with hepatitis C virus (HCV) genotype 1 infection, who received pegylated interferon alfa-2a or 2b plus ribavirin and telaprevir at 750 mg daily for 12 weeks. Thirty-four patients were treatment naive.

Thirty patients completed treatment, six are undergoing treatment, and three are awaiting post-treatment assessment. Of 16 patients who completed a full treatment course, 62.5% met sustained virologic response after 12 weeks (SVR12). Two patients relapsed once treatment was completed, and another patient stopped treatment because of intolerance, but achieved SVR after 3 weeks of therapy.

The combined cost for the first 20 patients treated was $1,100,974, an average cost of $55,040 per patient that included growth factor support. The mean cost for each patient who completed the program was $70,236.

“There was a very high discontinuation rate and the expense was very high particularly given the modest SVR rates,” Rice said at the conference. “Cost-effective responses are needed to best determine how to utilize the therapy in prisons.”

For more information:

Rice JP. #651. Presented at: Digestive Disease Week 2014; May 3-6; Chicago.

Disclosure: Lucey reports grant and research support from AbbVie, Vertex Pharmaceuticals, Gilead Sciences and Salix Pharmaceuticals.