For the HCV drugs discussed on this board and the ones listed in #msg-28837898, the patent lives will run out before the “reservoir inflow” slows to an appreciable degree.
HCV Reservoir math bears you out -
Current inflow in US - assume 25k per year (estimates range from 19k to 40k and about 20% self cure)
Cure rate in US - about 40% per treatment (of naive patients)
Treatment rate in US - somewhere between 35k and 150k patients per year (this is just short of a WAG - I can't find any direct ribivarin script numbers so have to back into it from $ spent on drugs which sources peg as around $3B/Yr for the world. My guess is half is US. Given treatment cost of $20K this equates to 75k patients per year but the uncertainty is large, hence the large range.)
Size of current infected US population - 3.8M (some estimates are a little above 4M, but the estimates are old and to be conservative ...)
Conclusions:
1) Right now we are NOT curing patients very significantly faster than newly infected patients are entering the pool - 35k-150k patients treated per year * 0.4 cure rate= 14k to 60k patients cured per year vs 25k new chronic infections.
2) The pool is becoming enriched with treatment resistant - at a substantial, but not huge, rate. Sample calculation for 10 years from now assuming no new therapies, assuming current pool is entirely treatment naive and assuming no deaths from other causes (so that the only exit from the pool is cure)... then in 10 years the pool will have shrunk at most to about 3.4M (from 3.8M now), and around 0.9M of that pool will be people who failed treatment.
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