New medicine for hepatitis C could lower the cost of treatment in the SUS

The new drug ravidasvir, used in combination with sofosbuvir, which the Instituto de Tecnologia em Fármacos (Farmanguinhos) of the Oswaldo Cruz Foundation (Fiocruz) holds the registration, could reduce by up to 20% the cost of treating hepatitis C by the Unified Health System (SUS), currently between R$ 6.2 thousand and R$ 6.5 thousand per patient. The estimate is made by the director of Farmanguinhos, Jorge Mendonça.

Through Farmanguinhos, Fiocruz signed this week a partnership agreement to register ravidasvir at the National Health Surveillance Agency (Anvisa). The technical and scientific partnership was signed with the non-governmental organization (NGO) Drugs for Neglected Diseases Initiative (DNDi) and the Egyptian pharmaceutical company Pharco Pharmaceuticals.

Jorge Mendonça detailed that the Egyptian pharmaceutical company Pharco carried out tests, together with DNDi, to show the effectiveness of ravidasvir, together with sofosbuvir, in the populations of Thailand and Malaysia. An average cure rate of 97% was recorded.

“A fairly high average, compared to more modern standards used for effective treatment of hepatitis C,”

he said.

Hepatitis C is an inflammation of the liver caused by the HCV virus that, when chronic, can lead to cirrhosis, liver failure and cancer.

Phases

After signing the agreement, Mendonça explained that the next step will be to submit the drug for approval at Anvisa. Then, wait for the record to be published by the Agency to subsequently provide it to the Ministry of Health for the treatment of hepatitis C, together with sofosbuvir. Jorge Mendonça estimates that this is a long process, which should take between a year and a year and a half.

“However, we understand that the more offers for the treatment of hepatitis C are available in the SUS, we bring more possibilities for doctors and more possibilities for patients to use medicines that are first-line and that can bring more comfort and more adherence to treatment on the part of these patients”,

stated the director of Farmanguinhos.

In addition to sofosbuvir, Farmanguinhos already has registration for the antiviral daclatasvir, which reinforces the Institute’s role as a supporter of the Economic and Industrial Health Complex (Ceis) and promoter of national independence in the treatment of hepatitis C.

“For a long time, there weren’t many effective treatment options for hepatitis C. Now, however, with the drugs developed by Farmanguinhos, there are already chances of a cure”,

says Mendonca.

“Nowadays, it is a treatment, on average, of 12 weeks, with an effective cure rate above 95%”. The director analyzed that with the registration of Ravidasvir, there will be no increase in the cure rate.

“But we can, in the future, which is one of the objectives of transferring Ravidasvir as well, reduce the cost of treatment to the SUS and, with that, the chance of increasing access to populations currently not served also becomes more sustainable by the SUS.”

The main objective of registering Favidasvir is for Fiocruz to be able to contribute to the budgetary sustainability of this program for the treatment of viral hepatitis by the SUS, which is quite costly for the Ministry of Health, argued Jorge Mendonça.

active search

According to the Epidemiological Bulletin of Viral Hepatitis, released by the Ministry of Health in June 2022, 718,651 cases of viral hepatitis were confirmed in Brazil registered in the Notifiable Diseases Information System (Sinan), in the period from 2000 to 2021. hepatitis B, 279,872 (38.9%) for hepatitis C and 4,259 (0.6%) for hepatitis D.

As the cases that occurred during the covid-19 pandemic are unknown, Jorge Mendonça said that the next step that the viral hepatitis programs in the world will take is called “active search”. That is, instead of waiting for the patient to come in search of treatment, mass tests will be carried out to treat these patients, since hepatitis C, in the first moments and even in the first years of the disease, does not cause symptoms. The idea is to seek out these individuals and treat them soon before the hepatitis C becomes chronic in them. “This is fundamental for the effectiveness of the treatment and for the health of the patient”, concludes Mendonça.

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