Treatments and treatment centers

Providing care and treatment to persons infected with viral hepatitis can greatly improve their health outcomes and prevent transmission of these infections to others. Since 2006, Egypt has made great progress in the management of viral hepatitis in establishing a National Committee for the Control of Viral Hepatitis with 23 affiliated viral hepatitis treatment units distributed all over the country. Through these centers, a Viral Hepatitis National Treatment Program was launched in 2008.  The main initial target of this governmental program was to provide antiviral medications at a reduced cost or even free for those who are not covered with the Health Insurance Organization (HIO).  The role of these centers was then extended to be referral centers providing integrated care for the viral hepatitis patients, including for example screening for hepatocellular carcinoma, and to act as nuclei to establish a network for liver transplantation centers. Moreover, insured patients (i.e., between 45%-50% of the population in Egypt) can obtain free HCV treatment in 25 centers related to HIO. Viral hepatitis treatment can also be obtained in private facilities, but at a very high cost (six fold the reduced price of National Treatment Centers). Between 2006 and 2012, more than 220 000 HCV patients were treated in National Treatment Centers and HIO centers (CDC, Morb Mortal Wkly Rep, 2012). Outside the official National Treatment Program, Egypt has also provided treatment to 300 children, thanks to collaboration with NGOs and pharmaceutical companies.

 

The Egyptian viral hepatitis treatment program is one of the largest treatment programs instituted by a resource-limited country. The estimated cost of this program to the Egyptian government is $80 million annually, which covers 40% of the total costs; the remaining 60% is paid by insurance companies (50%) and patients (10%).

 

There are currently two treatment regimens used in the National Treatment Program:

 

- Dual therapy with pegylated interferon and ribavirin: This treatmen regimen is for 48 weeks and, as of the end of 2014 will be used mainly for F1 and F2 fibrosis patients. Thanks to market competition and availability of a local biosimilar of pegylated interferon (Reiferon Retard®, Minapharm©), the price of a standard 48-week course of HCV dual therapy  has been progressively driven down through negotiations with the pharmaceutical manufacturers, decreasing more than six-fold in the last 6 years. Currently, one full course of HCV standard dual therapy costs the Egyptian government <$2,000 (Ford et al., Clin Infect Dis, 2012).

 

- New triple therapy with Sofosbuvir, pegylated interferon and ribavirin: The newly recommended treatment regimen in Egypt will be Sofosbuvir in combination with pegylated interferon and ribavirin for 12 weeks, given in priority to patients with bridging fibrosis (F3) and compensated cirrhosis (F4). In March 2014, an agreement was signed between the Egyptian government and Gilead for the purchase of Sofosbuvir at the cost of 900 USD for 12 weeks of treatment within the national treatment program. These new treatment regimens are expected to increase sustained virological response rates in genotype 4 patients up to 95% from 60% with combined pegylated interferon and ribavirin.

 

Note: At the moment, oral interferon-free regimens are NOT given as part of the national treatment program in Egypt, but discussions are ongoing with various companies (AbbVie and Janssen) for their evaluations.

 

 

 

NEWS & EVENT

Introduction of Sofosbuvir in Egypt

In July 2014, Gilead and the Egyptian government signed an agreement for a treatment expansion of Sovaldi® (Sofosbuvir). Read more

Scientific Advisory Board Meeting

The Scientific Advisory Board Meeting was held in Paris February 15-16, 2013.

Read more



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