Hepatitis C drug a costly but promising cure

Sallie Wickens' life followed a death-defying narrative that traced the medical arc of hepatitis C:

A blood-transfusion infection after a car accident in 1959, when she was 5; a positive test for the virus when she was 30; 10 years of deteriorating health; debilitating interferon drug treatments that didn't work; a liver so damaged she needed a transplant.

And then, her doctor, hepatologist Laura Alba, walked into an exam room last month at St. Luke's Hospital and gave Wickens, 60, a big smile.

Six months after she finished taking a new drug called Sovaldi, along with an old antiviral, ribavirin, Wickens remains free of the virus.

"You are cured," Alba said.

When Sovaldi hit the market in December 2013, it was welcomed as the first in a series of wonder drugs that would revolutionize treatment of hepatitis C, a chronic disease that can lead to cirrhosis and liver failure.

Earlier hepatitis C drugs had wretched side effects and offered at best a 50-50 shot at a cure. Sovaldi, when used with other drugs, cures more than 90 percent of patients with relatively mild side effects.

"This is one of the most exciting events in modern medicine," said Emalie Huriaux, director of federal and state affairs for Project Inform, an advocacy group for people with hepatitis C and HIV.

But Sovaldi also became known as "the $1,000 pill," with a list price of $84,000 for a three-month course of treatment. Adding other drugs, tests and a doctor's care put the total cost of a cure at about $150,000. That's roughly double what the previous course of treatment cost.

With an estimated 3.2 million Americans suffering chronic hepatitis C infections, the expense would be staggering. State Medicaid programs and commercial insurance plans quickly restricted Sovaldi to the sickest patients.

A year later, Sovaldi and other new hepatitis C drugs appear to be living up to their promises, while the anxieties about their prices are easing.

Meanwhile, new hepatitis C drugs just as effective as Sovaldi have entered the market, setting off a price war. Sovaldi's manufacturer, Gilead Sciences, said discounts on its hepatitis C drugs would average 46 percent this year.

Hepatitis C is most common in the baby boom generation, and a government task force recommended in 2013 that everyone born between 1945 and 1965 be tested for the virus.