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TOPIC: SOF/Dac could it work it eight weeks?

SOF/Dac could it work it eight weeks? 3 years 7 months ago #703

  • Johnboy
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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
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SOF/Dac could it work it eight weeks? 3 years 7 months ago #707

  • Alsdad
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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.
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SOF/Dac could it work it eight weeks? 3 years 7 months ago #708

  • LondonGirl
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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
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SOF/Dac could it work it eight weeks? 3 years 7 months ago #709

  • Johnboy
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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
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SOF/Dac could it work it eight weeks? 3 years 7 months ago #710

  • LondonGirl
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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
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SOF/Dac could it work it eight weeks? 3 years 7 months ago #725

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

www.pmlive.com/pharma_news/limited_acces...the_spotlight_788876

It's a purely cost-driven decision to treat G1's with Harvoni.
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SOF/Dac could it work it eight weeks? 3 years 7 months ago #727

  • LondonGirl
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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
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SOF/Dac could it work it eight weeks? 3 years 7 months ago #730

  • Sirchinenge
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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.
Last Edit: 3 years 7 months ago by Sirchinenge.
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SOF/Dac could it work it eight weeks? 3 years 7 months ago #758

  • klhilde
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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.
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SOF/Dac could it work it eight weeks? 3 years 7 months ago #761

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

12 weeks works better.

Get 12 weeks.
YMMV
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SOF/Dac could it work it eight weeks? 3 years 7 months ago #763

  • Nadia
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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
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SOF/Dac could it work it eight weeks? 3 years 7 months ago #767

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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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