How Much Does It Cost?

Written by PATRICIA BECK/Detroit Free Press

How Much Does Incivek Cost?

Jack Kevorkian’s longtime aide and friend is one of the thousands of Americans cured of hepatitis C by a new treatment.

Neal Nicol and Kevorkian contracted the liver disease in the 1960s when they used themselves as guinea pigs in a Pontiac hospital experiment they devised to test the value of cadaver blood for transfusions, Nicol said last week.

The recent approval of two new drugs offers the first good treatment options in years for the 170,000 Americans newly diagnosed with the liver disease.

But the drugs are expensive and may cause unwanted side effects.

Nicol and Kevorkian apparently contracted a milder strain of the virus that caused no symptoms for them.

Still, Nicol decided to participate in a Henry Ford Hospital study in 2009 of an experimental drug called Incivek because he knew the disease could cause fatal complications down the road, particularly in old age.

Nicol just made the cutoff for the study, which was limited to people under the age of 70.

Kevorkian, now 83, was too old.

Today — as Kevorkian remains hospitalized after a fall — Nicol is clear of the virus, he said. “I’d recommend the drug to anyone.”
Hepatitis C drugs offer promise at a high cost

Two newly approved hepatitis C drugs may bring a cure to thousands of Americans not helped by previous treatments. But the drugs are costly and can cause unwanted side effects.

The drugs –Victrelis and Incivek– have generated excitement among many of the 170,000 Americans who are diagnosed each year with the liver disease because the treatments might help those who haven’t responded to other drugs.

“There’s going to be a great demand,” said Dr. Stuart Gordon, chief of hepatology at Detroit’s Henry Ford Hospital. “A lot of prior non-responders will give it a try again.”

Some studies show the drugs can cure as many as four out of every five patients who take them along with two conventional medicines.

Gordon said research suggests people more recently diagnosed with hepatitis C may benefit most from the drugs.

An estimated 4 million Americans have hepatitis C, though many are unaware of it because the virus is slow-growing and can linger for years without symptoms.

The drugs recently were approved for genotype 1 hepatitis C, the most common strain of six types.

Merck, manufacturer of Victrelis, said the drug will cost $26,000 to $48,400 for a course of treatment, depending on how long a patient takes it.

Vertex Pharmaceuticals, manufacturer of Incivek, said its drug will cost $49,200 for a course of treatment. The manufacturers have programs to help many uninsured or low- to middle-income patients get the drugs for free or at reduced costs.

Blue Cross Blue Shield of Michigan, which, as the state’s largest health insurer, often sets reimbursement trends in Michigan, is reviewing whether it will cover either drug, said spokeswoman Helen Stojic.

Still unclear, Gordon said, is whether patients who aren’t helped by the new drugs will develop resistance to similar medicines.

Incivek also can cause rashes. Victrelis can trigger anemia. Both drugs are used in combination with interferon and ribavirin, two hepatitis C medicines with their own side effects.

“These are complex and expensive drug regimens that will require careful patient education, motivation and adherence to be successful,” Gordon said.

The drugs aren’t recommended for people who have other medical problems, such as uncontrolled diabetes, lung or psychiatric problems because those conditions could get worse, he said.

Gordon said he considers both drugs to be major advances, but other medicines are being tested that may be even more effective or allow patients to avoid interferon, which can cause severe fatigue, he said.

At Ford, “each case will be evaluated individually by our team of liver specialists to determine whether these newer agents are advantageous for them or whether perhaps other options may be available,” Gordon said.

People who don’t have insurance may be eligible for free care in a clinical study testing the two drugs with other medicines, Gordon said.

Many patients contracted the disease from blood transfusions prior to the early 1990s when the U.S. instituted strict precautions to improve the safety of its blood supply. Drug users who share needles, spoons and straws also are at higher risk of getting the disease.

For information on clinical studies of hepatitis C drugs, call the Henry Ford hepatology department at 313-916-1973.