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Survey Identifies Sofosbuvir (Sovaldi) as ‘Defining’ HCV Therapy

Sofosbuvir-based regimens expected to dominate treatment of genotype-1 infections

In a new survey, Decision Resources Group, a health-care research firm based in Burlington, Mass., finds that, for the treatment of hepatitis C virus (HCV) infections, regimens containing sofosbuvir (Sovaldi, Gilead) account for approximately 30% of the patient treatment share across key genotypes at 1 month after launch.

In contrast, regimens containing simeprevir (Olysio, Janssen) have captured less than 10% of the genotype-1 patient treatment share 2 months after the drug’s launch.

Surveyed HCV specialists are also expecting to further increase their uptake of sofosbuvir among their genotype-1, -2, and -3 patients, with sofosbuvir regimens accounting for most of the patient treatment share, whereas the genotype-1 treatment share for simeprevir is expected to be nearly 20% in the next 6 months.

In addition, the survey data show that gains for sofosbuvir and simeprevir are at the expense of telaprevir (Incivek, Vertex) and boceprevir (Victrelis, Merck) — a finding underscored by interviewed specialists indicating that they plan to discontinue future use of first-generation protease inhibitors.

Other key findings include the following:

  • More than 10% of surveyed HCV specialists reported prescribing the off-label combination of sofosbuvir and simeprevir.
  • Nearly 10% of surveyed simeprevir non-prescribers did not plan to ever prescribe the drug, whereas none of the surveyed specialists indicated they would not prescribe sofosbuvir.
  • Surveyed specialists reported increases in both the number of HCV patients under their care and in the number of patients on active treatment, suggesting the de-warehousing of patients for new regimens.
  • The HCV specialists reported recently receiving general inquires and/or prescription requests for sofosbuvir or simeprevir; prescribers were more likely to report receiving patient requests for the new agents as opposed to non-prescribers, suggesting possible patient influence on uptake.

“Cost is the leading prescribing barrier for both Olysio and Sovaldi,” said analyst Brenda Perez-Cheeks, PhD. “Although most surveyed prescribers did not indicate major payer obstacles, many non-prescribers reported experiencing reimbursement obstacles, suggesting that reimbursement is a barrier to prescribing. With the impending availability of several safe and highly efficacious all-oral interferon-free regimens, especially for genotype-1 infections, cost will emerge as an important differentiator, and follow-on therapies will have to offer competitive pricing to penetrate this highly dynamic space.”

Source: BioTrends Research Group; March 19, 2014.

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