All Swiss hepatitis C sufferers can access costly drugs like Harvoni

Gilead has been under pressure to reduce the prices of its highly expensive hepatitis C drugs like Harvoni Gilead

All patients suffering from hepatitis C can be treated with the drugs Harvoni and Epclusa from next month, after the Federal Office of Public Health lifted restrictions allowing the medicines to be reimbursed by mandatory health insurance.

The two drugs will be available to all patients irrespective of the level and stage of infection, the office said in a statement on Tuesday. The brand-name drugs (sold as Harvoni or Epclusa) manufactured by American pharmaceutical Gilead costs between CHF33,000 to CHF60,000 ($34,048 to $61,713) for the 8-12-week therapy.

The decision follows a softening of the government’s stance. Earlier these drugs were only available to those with an advanced form the disease. Others – around half of all sufferers – were forced to buy cheap generics from countries like India, often through buyer’s clubs. 

In April, plans were announced to make it easier for high-risk patients like drug addicts, as well as HIV and Hepatitis B sufferers, to access the two drugs even if the disease is only in an intermediary stage.

From July 1, the health office made Zepatier, produced by pharma company Merck Sharp & Dohme, available to all patients from after also allowing it to be reimbursed by mandatory insurance. The 12-week treatment costs CHF31,000 ($31,952) per patient and was previously only available to those with an advanced form of the disease.  The same occurred for the drug combination Viekirax/Exviera from September 1. These two treatments are taken by 63% of patients. 

Hepatitis C affects between 50,000 to 80,000 Swiss residents, or 0.7% of the population, compared to 3% worldwide. The number of new Swiss cases has been stable since 2006. 

Price point 

The recent changes result from negotiations between the health office and the biopharmaceutical company Gilead Sciences Inc, which accepted sizeable price reductions of Harvoni and Epclusa, the health office declared. 

The Swiss health office expects to have to cover additional costs only for a limited period, despite an expected doubling of the number of treatments. 

The unrestricted reimbursement of new hepatitis C drugs by Swiss mandatory health insurance is in line with international health directives, which recommend full access to such medicines as soon as it becomes economically viable. 

Only specialist doctors will be able to prescribe the new drugs to patients and decide when they are needed. The new measure is limited to an initial two-year period, subject to verification. 

Hepatitis C is an inflammation of the liver that occurs due to an infection by the Hepatitis C virus. It is transmitted via the blood of a person with disease, usually through shared syringes or insufficiently sterlised medical or tattoo instruments. Rarely, it is transmitted through sexual intercourse or from mother to child. Symptoms include fatigue, loss of appetite, nausea, vomiting, joint pains and jaundice.  

However, around 75% of those infected show no symptoms at all and are thus unaware they have the disease. For the majority (70-80%), it develops into a chronic infection and remains in the liver. After several decades, some (5-30%) develop liver scarring or cirrhosis and are more likely to get liver cancer. Chronic Hepatitis C sufferers constitute the largest demand for liver transplants. Most diagnosed infections can be traced back to intravenous drug use but transmission among men who have sex with men is on the rise.