A new hepatitis C drug has come onto the scene — Merck’s boceprevir — after a 10-year lull in HCV therapies entering the market. The FDA’s approval of boceprevir, which will be marketed under the name Victrelis, is a victory for both Merck and HCV patients, as well as for supporters of “cocktail” drug therapies.
What is a therapeutic cocktail, you might ask? There is a growing belief in the medical community that patients with certain viral infections (as well as cancers and other diseases) respond better to a combination of drugs, as opposed to just one drug. Supporting this methodology is a rising trend in drug development in which research trials are increasingly focused on combination treatment regimens, where newer drugs are paired with established therapies.
Merck’s boceprevir is one of these drugs, and has shown success rates (patients cured of the virus) at around 66% when paired with interferon (an injectable drug marketed by Roche as Pegasys) and ribavirin (a pill made by several generic firms). Treatment with just those two drugs, currently the standard protocol for HCV treatment, was found to be less than 40% successful. Adding in boceprevir has also shown that patients are able to complete therapy in a much shorter timeframe.
However, boceprevir’s status as the only new HCV treatment available will be short-lived. Strong competition will soon come from telaprevir, another HCV treatment made by Vertex that is also expected to gain FDA approval this month. The two drugs work in a similar fashion, blocking the enzymes that help the virus grow, and both must be taken in combination with interferon and ribavirin.
Telaprevir, which will be marketed as Incivek, is expected to control the market as it achieved a higher (79%) success rate in clinical trials, though Merck’s larger marketing infrastructure could give it a run for its money. Overall the HCV market is predicted to be worth more than $3 billion in coming years.
Some doctors make the valid point that such a drug cocktail regimen is difficult to follow, especially since the ribavirin, boceprevir, and telaprevir pills must be taken several times daily. There are also risks of harsh side effects and, considering the steep price tag for these biologic antiviral medicines, such a regimen will be expensive.
But overall, the higher rate of patient wellness is likely worth the trouble for HCV sufferers – who are at risk of chronic or potentially fatal liver problems — as well as for health providers, who will be able to cure and release chronic sufferers on a more effective and efficient basis.
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