Biotech Values

[DewDiligence]

Incidence of Newly-Diagnosed HCV in US Down 90% Since 1980s

[However, the millions of people with old HCV infections are getting sicker, as can be seen from the chart in #msg-30190435.]

http://www.bloomberg.com/news/2011-02-14/new-hepatitis-c-infections-fall-in-u-s-linked-to-needle-drugs.html

›By Meg Tirrell - Feb 14, 2011

The rate of new hepatitis C infections in the U.S. fell more than 90 percent in the 25 years ending in 2006 as fewer Americans started using injected drugs such as cocaine, crack cocaine and heroin, a study showed.

The average incidence of new infections declined to 0.7 per 100,000 people in 1994 to 2006, from 7.4 per 100,000 in 1982 through 1989, according to a report today in the Archives of Internal Medicine. Injected-drug use was still the most common risk factor in contracting the disease, the study showed.

About three million to four million people in the U.S. have chronic hepatitis C, which can lead to liver damage, said Miriam Alter, an epidemiologist and author of the study. As the number of new infections declines, companies led by Merck & Co. and Vertex Pharmaceuticals Inc. are advancing new experimental medicines for the aging population of hepatitis C patients, who are more susceptible to the disease’s effects.

“Our concern is that we will be seeing more cases of liver disease due to hepatitis C in the near future, because while newly acquired cases have declined, the population of currently affected people is aging,” said Alter, director of the Infectious Disease Epidemiology Program at the University of Texas Medical Branch in Galveston, in a Feb. 11 telephone interview. “Once someone reaches advanced liver disease, they’re almost impossible to treat, so you want to identify people as early as possible.”

Hepatitis C often persists as a chronic condition that causes nausea, weakness and exhaustion as it destroys the liver over time. Interferon, the standard of care when paired with the generic drug ribavirin, works by boosting the immune system. The yearlong treatment causes aches and pains similar to the flu that may last the entire year of treatment and cures about half of those who can tolerate it.
Standard Treatments

Roche Holding AG of Basel, Switzerland, sells a version of interferon under the brand name Pegasys, while Merck sells a form called PegIntron.

Merck, based in Whitehouse Station, New Jersey, and Cambridge, Massachusetts-based Vertex are competing to market the first new hepatitis C medicine approved in almost a decade. Merck’s boceprevir and Vertex’s telaprevir belong to a family known as protease inhibitors that work by blocking an enzyme that viruses use to copy themselves.

Both companies said in January that their drugs were granted priority review from the U.S. Food and Drug Administration, a process that typically takes six months. Johnson & Johnson, based in New Brunswick, New Jersey, agreed in 2006 to pay an upfront fee of $165 million to jointly promote the Vertex drug.

Peak sales of the medicines could reach more than $4 billion a year at “premium pricing” of more than $40,000 per year, Cowen & Co. analyst Phil Nadeau estimates.

‘Sizeable Opportunities’

“It is estimated that there are several hundred thousand patients in the U.S. who have been treated unsuccessfully,” Nadeau wrote in an October research note. “Both front-line and non-responder patients represent sizable opportunities that may be addressed with new HCV therapies, and we believe that a new drug class that possesses synergistic activity with other agents has blockbuster potential.”

While the rate of new hepatitis C infections has declined, preventative measures should still be employed, Alter said. She co-wrote the paper with the Atlanta-based Centers for Disease Control and Prevention’s Ian T. Williams, Beth P. Bell and Wendi Kuhnert, and worked with the agency from 1981 to 2006.
Drug Users

“Many users of injection drugs had been previously incarcerated or in a drug treatment program, suggesting that providing primary prevention services in correctional and drug treatment settings could be an effective means to further reduce hepatitis C incidence in the United States,” the authors wrote.

Those already infected with the disease may have contracted it while experimenting with injected drugs in the 1960s, when the practice was more popular, Alter said.

“A lot of them acquired the infection as a result of experimenting with drugs and then went on and stopped using or didn’t experiment anymore,” she said. “There are some people who have this perception that hepatitis C is a street-user disease, which it is, but the majority of those infected now and who are developing chronic liver disease are not street users, and they can be accessed if we would screen for them.”‹