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Study Finds Drop in Sovaldi Use

New all-oral treatment expected in the fall

An analysis conducted by the CVS Health Research Institute has provided insights regarding patients treated with Sovaldi (sofosbuvir, Gilead), an expensive new treatment for hepatitis C virus (HCV) infection introduced in December.

The data show that from May through August 2014 there has been a plateau and downward trend in the use of Sovaldi. This suggests that another surge of patients will begin therapy when a number of new therapeutic regimens of similar efficacy and shorter duration are introduced in the fall, the report says.

“Despite the current plateau and decline in Sovaldi utilization, we expect to see another peak in spending for hepatitis C medications upon the release of the new all-oral treatment,” said Troyen A. Brennan, MD, Chief Medical Officer of CVS Health. “While the simplicity of the new treatment regimen may help reduce discontinuation rates, careful follow-up, such as that provided by pharmacies specializing in hepatitis C, in conjunction with the patient’s physician is still required to ensure patients are completing their course of therapy and deriving the maximum benefit.”

In clinical trials of Sovaldi, more than 95% of patients achieved cure rates, and almost all patients completed therapy, with only about 2% discontinuing treatment. However, clinical trials rarely capture the real-life challenges faced by patients taking a new drug, the report contends. The new CVS Health data also provide a first look at the use of Sovaldi outside of the clinical-trial setting and show therapy discontinuation rates of 8.1% — approximately four times higher than in clinical trials. Further, patients who were completely new to HCV treatment were more likely to discontinue therapy, a finding that has substantial implications for clinicians and their patients.

“While Sovaldi represents a breakthrough in the treatment of hepatitis C, this is an expensive drug that needs to be taken as directed for the full course of treatment in order to achieve the maximum clinical benefit demonstrated in the trials,” Brennan added. “Our data suggest that in order to help patients achieve their treatment goals, we need to ensure that those patients who are prescribed Sovaldi are adherent to their full course of therapy.”

Researchers analyzed discontinuation rates for nearly 2,000 patients managed by CVS/caremark, the CVS Health pharmacy benefit management business, who filled prescriptions for Sovaldi since December. While overall discontinuation rates were around 8%, discontinuation rates for treatment-naïve patients who had not previously been treated for HCV infection were the highest at 8.7%. Patients who had been treated for HCV infection, and presumably failed previous therapy, discontinued Sovaldi only 5.3% of the time.

Source: CVS Health Research Institute; September 17, 2014.

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