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Hepatitis C Medication Could Enable Hundreds of Kidney Transplants for the Critically Ill

Written by: Darren Young on Tuesday, April 19, 2016 Posted in: Specialty Pharmacy

kidneyTransplantAmid the controversy over price-gouging and payer rationing, it’s easy to forget that those ground-breaking hepatitis C medications really have the potential to help critically ill patients. And now, with some new clinical trials underway, these drugs may soon be able to save more than those suffering from chronic hepatitis C.

In a March 18 article in Stat News, Elie Dolgin reported that two transplant surgeons, one affiliated with the University of Pennsylvania and the other with Johns Hopkins University, have each established a clinical trial to transplant hepatitis C-infected kidneys into patients with renal failure who do not have hep C.1 While such a practice would have been unthinkable before Harvoni and its counterparts, the efficacy of these specialty drugs has convinced the surgeons that infected kidneys can be cleared of the hepatitis C virus (HCV) after transplant.

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Naturally, these clinical trials have their critics. But with more than 100,000 candidates currently waiting for kidneys on the Organ Procurement and Transplantation Network’s list (the network has approximately 21,000 candidates waiting, in total, for all other organs), the need for kidneys is great.2 For patients who are at high risk of mortality while they continue to wait, an HCV-infected kidney could be their only hope for life and, therefore, well worth taking a chance.

So that’s why Dr. Christine Durand, from Johns Hopkins, and Dr. Peter Reese, from Penn, are working with Merck, the drug company that makes Zepatier. This drug proved 94% to 100% effective in treating hepatitis C3. According to Stat News, Merck is offering Zepatier, priced at $54,500 for a 12-week regimen, at no charge and is “providing additional financial support for staff and lab tests.”4

If these trials gain regulatory approval, other transplant centers are expected to follow suit. With Merck providing both the drugs and additional funding, I wonder how this will affect HCV medication pricing overall. Will Merck’s competitors, like Gilead Sciences, offer their drugs to similar transplant trials? Or will they be forced to lower prices to remain competitive? I’m looking forward to watching how all this plays out and to seeing how specialty pharmacies can be involved.

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