Home Forums Main Forum Patient Stories SOF/Dac could it work it eight weeks?

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  • #1776
    Johnboy
    • Topics: 16
    • Replies: 75
    • Total: 91
    • Guardian Angel
    • ★★★★★
    @johnboy

    A must see video on the other threads………… And some great information from JF. Don’t miss it.
    I just wanted to start another thread as this doesn’t really fit anywhere else.

    I did note that in the speech (on the video I mention) there was a reference to the EASL recommendations which got me thinking. I have wondered why they recommended 12 weeks for SOF/Dac when the data was mainly over 24 weeks. Yes, there is still some data suggesting 12 weeks is fine but I had thought that they would be erring on the side of caution. This is for non cirrhotics of course. The speaker made mention of the cost in a way that made me think the real basis for the decision, in the absence of abundant data, was indeed cost.

    But…. If Dac has a higher log kill than Led why would it not work just as well? I wonder if in fact there will be soon be eight week courses for G1 with the Dac regime. That is for the low viral load patients etc etc.

    Just musing…….


    G1 58yo F1 54,000 viral load Relapser 2003/4 Sof/Dac started 21/9/2015

    #1780
    Avatar photoAlsdad
    • Guardian Angel
    • ★★★★★
    @alsdad

    That makes sense. Dac’s only just been approved in the US, and Harvoni is fairly recent in Europe.So I expect we’ll be hearing a lot more about Sof/Dac G1 treatment in the coming months.

    #1781
    Avatar photoLondonGirl
    • Guardian Angel
    • ★★★★★
    @londongirl

    Isn’t DAC cheaper? Or us it more expensive in the UK ?


    GT1a Dec14 F2/8.7 VL 900000-2.5M
    Jan16 Hepcivir-L MonkMed/Redemption
    Baseline: VL 913575 Alt 76 Platelets low
    Wk2 VL1157 Alt 23
    DET Wk 8 VL 32 Alt19 ‘In the slow lane’
    June16 Fibro 5.7 F0/1 LIF 1.5
    Wk 11 VL<12 Alt 13 Det/Unq
    Extending tx 12 wks Mylan Sofo/Dac MonkMed
    Wk 14 VL <12 Det/Unq
    Wk 16 VL UNDETECTED
    Wk 22 + 4 Wks Sunprevir FixHepC
    Wk 24 UNDETECTED Alt 13
    Wk 12 post tx SVR12 Wk 26 SVR24
    Thank-you Tim, Dr Debasis @ MonkMed & Dr Freeman @ Fix HepC

    #1782
    Johnboy
    • Topics: 16
    • Replies: 75
    • Total: 91
    • Guardian Angel
    • ★★★★★
    @johnboy

    Generically it is cheaper by a fair margin.

    I would not be considering price unless I had to. Saying that however, it seems to be just as good as the big H. Just that the there is not sufficient data from a large trial base.


    G1 58yo F1 54,000 viral load Relapser 2003/4 Sof/Dac started 21/9/2015

    #1783
    Avatar photoLondonGirl
    • Guardian Angel
    • ★★★★★
    @londongirl

    I am interested re health authorities. They ‘may’ offer 8 weeks of something or the other in the UK, so you could top it up with an extra bottle if waiting for that eg? Just wondered why if DAC is cheaper to them, why it’s all about Harvoni for GT1s and talk of DAC as being expensive when I’ve read it’s cheaper.


    GT1a Dec14 F2/8.7 VL 900000-2.5M
    Jan16 Hepcivir-L MonkMed/Redemption
    Baseline: VL 913575 Alt 76 Platelets low
    Wk2 VL1157 Alt 23
    DET Wk 8 VL 32 Alt19 ‘In the slow lane’
    June16 Fibro 5.7 F0/1 LIF 1.5
    Wk 11 VL<12 Alt 13 Det/Unq
    Extending tx 12 wks Mylan Sofo/Dac MonkMed
    Wk 14 VL <12 Det/Unq
    Wk 16 VL UNDETECTED
    Wk 22 + 4 Wks Sunprevir FixHepC
    Wk 24 UNDETECTED Alt 13
    Wk 12 post tx SVR12 Wk 26 SVR24
    Thank-you Tim, Dr Debasis @ MonkMed & Dr Freeman @ Fix HepC

    #1798
    Avatar photoAlsdad
    • Guardian Angel
    • ★★★★★
    @alsdad

    Sov/Dak costs the NHS about £20,000 more than Harvoni per 12 weeks:

    http://www.pmlive.com/pharma_news/limited_access_to_new_hep_c_treatments_under_the_spotlight_788876

    It’s a purely cost-driven decision to treat G1’s with Harvoni.

    #1800
    Avatar photoLondonGirl
    • Guardian Angel
    • ★★★★★
    @londongirl

    Ah – How typical of English bureaucracy !


    GT1a Dec14 F2/8.7 VL 900000-2.5M
    Jan16 Hepcivir-L MonkMed/Redemption
    Baseline: VL 913575 Alt 76 Platelets low
    Wk2 VL1157 Alt 23
    DET Wk 8 VL 32 Alt19 ‘In the slow lane’
    June16 Fibro 5.7 F0/1 LIF 1.5
    Wk 11 VL<12 Alt 13 Det/Unq
    Extending tx 12 wks Mylan Sofo/Dac MonkMed
    Wk 14 VL <12 Det/Unq
    Wk 16 VL UNDETECTED
    Wk 22 + 4 Wks Sunprevir FixHepC
    Wk 24 UNDETECTED Alt 13
    Wk 12 post tx SVR12 Wk 26 SVR24
    Thank-you Tim, Dr Debasis @ MonkMed & Dr Freeman @ Fix HepC

    #1803
    Avatar photoSirchinenge
    • Guardian Angel
    • ★★★★★
    @sirchinenge

    That’s a very interesting post, Al!


    Sob/Dac from Oct 29 2015
    Geno 1b
    Fiberscan 9.9 Pre treatment
    Fiberscan 7.4 week 10
    VL 1.3 million pre treatment
    Week 2.5 VL 96
    Week 5.5 VL 17
    Week 10 VL UD
    SVR 3 UD
    SVR 16 UD
    Cured:
    All liver functions in normal ranges.

    #1830
    Avatar photoklhilde
    • Guardian Angel
    • ★★★★★
    @klhilde

    My take on this is that it’s a result of Gilead machinations.

    Gilead has been unwilling to participate with Bristol-Myers Squibb to get approval of the Sof/Dac combo in the US except on treating G3 … not in their financial interest, as Ledipasvir is a Gilead product. Gilead has been spending heavily on Harvoni ads, and most of the press and awareness in the US is all about Gilead’s products. Many doctors in other countries are following the US standard recommendations, for example my hepatologist in Thailand.

    Therefore the Chinese entities such as Mesochem likely perceive a greater demand and price inelasticity with the ledipasvir … and they simply price accordingly.

    When the Indian companies get approved with their Harvoni generic equivalents expect a price crash on the Led from China.

    But I still think it’s crazy to wait.

    And I personally think the Dac is better and have chosen accordingly …. BUT I’M NOT A DOCTOR.

    #1833
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    8 weeks is an economy measure to reduce the government costs of these medications.

    12 weeks works better.

    Get 12 weeks.


    YMMV

    #1835
    Avatar photoNadia
    • Guardian Angel
    • ★★★★★
    @nadia

    Perhaps NHS is planning to negotiate a better price for the Dac? I’ve heard that Bristol Mayers reporting a loss. Russia managed to negotiate a very good price for the Dac. £1.2K per bottle. That’s less than £4k for the course of 12 weeks!


    Virus not detected from 14.10.2015

    #1839
    Johnboy
    • Topics: 16
    • Replies: 75
    • Total: 91
    • Guardian Angel
    • ★★★★★
    @johnboy

    Thanks JF

    It seems a lot of decisions are cost based when it comes to our health.

    Your work is very much appreciated.


    G1 58yo F1 54,000 viral load Relapser 2003/4 Sof/Dac started 21/9/2015

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