INTERVIEW – While the Minister of Health had pledged to guarantee universal access to treatment for hepatitis C, some patients are still deprived of it.
“For more than two years, the exorbitant price of new hepatitis C treatments demanded by laboratories has led the government to ration access to care, in direct violation of our constitutional principles of access to health, thus delaying any public health policy to put an end to the hepatitis C epidemic in France”.
In a joint press release, Doctors of the World, SOS Hepatites and Comede fulminate: in 2017, in France, universal access to treatment for Hepatitis C is not effective. Among the 400,000 patients with the disease, some still cannot be treated, denounce the associations.
Blame it on the prices of these treatments – 28,700 euros for 12 weeks of Zepatier (MSD), 46,000 euros for drugs marketed by Gilead. On the ground, the hepatologists note, powerless, this problem. Victor de Lédinghen, head of the Hepato-Gastroenterology Department at the CHU Bordeaux, tells how patients remain deprived of treatment.
Are there any hepatitis C patients who cannot get treatment?
Victor de Ledinghen: Absoutely. Zepatier is only effective in patients with genotype 1B or 4. In addition, patients with genotype 3 can already be treated. This leaves all those with genotype 1A, 2, 5 or 6.
Currently, treatments exist but are reserved for patients who have developed fibrosis; the others remain excluded, while the latest recommendations from the HAS (Haute Autorité de Santé) recommend treating all patients, including those who do not have fibrosis. At present, for the latter, treatments remain contraindicated while they cure hepatitis C. This means that some patients do not have the right to a cure.
The Ministry of Health has however announced universal access to treatment…
Victor de Ledinghen : Yes, it’s a promise that Marisol Touraine made in May 2016. She had sworn that before the end of the year, ministerial decrees would be published in the Official Journal, allowing the contraindications to be lifted, and to offer universal access to treatment for hepatitis C. We are still awaiting the publication of these texts.
The Minister succeeded in obtaining a reduction in the price of Zepatier; an order published in the Official Journal on January 4 specifies the framework for access to this treatment. However, this does not guarantee, in practice, universal access for all patients with hepatitis C.
Do you know the reasons for this blockage?
Victor de Ledinghen: Yes, the prices of the treatments marketed by Gilead are still being negotiated with the CEPS (Economic Committee for Health Products) and we are told to wait for these discussions to be completed. In the meantime, patients who are not eligible for treatments cannot benefit from them. This represents a small number among all hepatitis C patients, but it is already too many.
Furthermore, during a presidential election, we are very concerned that the question will be put on hold; the next government may not have the will to guarantee this universal access. This is why it is necessary that the ministerial decrees be published in the Official Journal before the end of the presidential mandate.
.
