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Reuters Health Information (2013-02-28): Mass distribution of a generic hepatitis B drug could reduce liver cancer in Africa

Public Health

Mass distribution of a generic hepatitis B drug could reduce liver cancer in Africa

Last Updated: 2013-02-28 13:46:08 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Creating a generic version of the hepatitis B drug entecavir (Baraclude) could substantially lower the cost of large-scale treatment in Africa and reduce liver cancer deaths, a new study suggests.

Liver cancer is the leading cause of cancer death among African men, and it is linked to hepatitis B, the researchers say.

"The availability of inexpensive generic entecavir could enable it to be very cost-effective to treat many people living with hepatitis B and prevent many deaths from cirrhosis and hepatocellular carcinoma," study leader Matthew Barnhart told Reuters Health by email. When he led the study, he was working at Stony Brook University's Department of Preventive Medicine in Stony Brook, New York. Presently, he's at the US Agency for International Development (USAID)

In a presentation Feb. 21st at the annual meeting of the American College of Preventive Medicine in Phoenix-Scottsdale, Arizona, Barnhart compared two drugs approved by a panel convened by the World Health Organization to treat hepatitis B in resource-constrained areas: tenofovir and entecavir.

In long-term clinical studies, both drugs achieved virologic response rates of around 95%, with very low rates of resistance development and good safety profiles.

Tenofovir disoproxil fumarate at 300mg per day costs $83 per patient every year, while entecavir at 0.5mg per day costs about $7000 per patient per year, by its US price.

The low dosage required implies that a future generic entecavir could be cheap, Barnhart says. He estimated a cost of $17 per patient per year.

And with large-scale manufacture, that cost could drop to $5 per patient per year, Barnhart says.

Large-scale treatment could save $4300 per patient by avoiding the cost of healthcare for those who would have developed liver cancer, his study found.

An estimated 240 million people, or approximately 4% of the world's population, is living with hepatitis B, and so this is an important issue not only in Africa, but also in the rest of the world, Barnhart said.

He added, "I think it is important to highlight how inexpensive to manufacture entecavir could be, and to model how this may influence the cost-effectiveness of treating people who may not qualify for treatment under current recommendations from various expert bodies. The potential low cost of manufacturing of entecavir has not been widely recognized either by parties involved in developing recommendations or by groups that advocate with the pharmaceutical industry to increase access to essential medicines."

He urges, "Interested parties should work together to expedite access to generic entecavir and to support implementation of simplified HBV treatment in low and middle-income countries."

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