Health Canada approved a new treatment medication for hepatitis C. The drug brand named Epclusa is the newest DDA (direct anti-viral agent) developed and marketed by Gilead Sciences. The US FDA also approved Epclusa on June 28th.
Epclusa is a another fix-dose combination DDA that combines the drug sofosbuvir (brand name Sovaldi) and a new NS5A Inhibitor called velpatasvir. This is the same type of combination that has been the mainstay of hepatitis C treatment over the past few years. In 2013 sofosbuvir was the first first effective direct anti-viral hepatitis C treatment developed by Gilead Sciences that showed over 90% effectiveness in curing hepatitis C. In order to prevent resistance and to improve effectiveness at the same time, sofosbuvir has been used in combination with another type of DDA called NS5A Inhibitors, which includes daclatasvir, and ledipasvir. The combination of sofosbuvir with ledipasvir was made into 1 single pill marketed by Gilead under the brand name Harvoni.
There are 6 main genetic strains of the hepatitis C virus, genotypes 1 to 6. Harvoni (sofosbuvir + ledipasvir) has been demonstrated to effectively cure genotypes 1, 4, 5, and 6, while the combination of sofosbuvir and daclatasvir can effectively cure genotypes 1, 2, 3, 4. All with cure rates of 90% and greater. The advantage of Epclusa (sofosbuvir + velpatasvir) is that it has been shown in studies to effectively treat all 6 genotypes with greater that 90% cure rates. This means that physicians no longer need to order the HCV genotype test in patients who plan to take Epclusa.
Epclusa, however, does come at a lofty cost. Gilead has announced that Epclusa will be priced at around $900 per pill, which equals to roughly $75,000 for a 12 week course and $150,000 for a 24 week course for those who have cirrhosis.