Sovaldi use decreased; analysts anticipate rise with release of newer therapies for HCV

The rate at which patients have used sofosbuvir to treat hepatitis C virus infection has declined in recent months, according to an analysis performed by the CVS Health Research Institute.

The institute analyzed discontinuation rates for approximately 2,000 patients managed by CVS/Caremark, which has been filling prescriptions for sofosbuvir (Sovaldi, Gilead Sciences) since December, according to a news release. Researchers found a high discontinuation rate for treatment-naive patients and associated it with a decrease in Sovaldi use between May and August.

Data showed an overall discontinuation rate of 8.1%, approximately four times higher than in trials. Treatment-naive patients were more likely to discontinue therapy and did so at a rate of 8.7%, according to the research. By comparison, among patients who were previously treated and presumably failed HCV therapy, 5.3% discontinued treatment.

“While Sovaldi represents a breakthrough in the treatment of [HCV], this is an expensive drug that needs to be taken as directed for the full course of treatment in order to achieve the maximum clinical benefit demonstrated in the trials,” Troyen A. Brennan, MD, chief medical officer of CVS Health, said in the release. “Our data suggest that in order to help patients achieve their treatment goals, we need to ensure that those patients who are prescribed Sovaldi are adherent to their full course of therapy.”

During clinical trials for Sovaldi, more than 95% of patients achieved cure rates, and almost all patients completed therapy, with only about 2% discontinuing treatment, the release said.

“Despite the current plateau and decline in Sovaldi utilization, we expect to see another peak in spending for [HCV] medications upon the release of the new all-oral treatment,” Brennan said. “While the simplicity of the new treatment regimen may help reduce discontinuation rates, careful follow-up … is still required to ensure patients are completing their course of therapy and deriving the maximum benefit.”