SummaryOn April 9, the World Health Organization (WHO) issued its first guidance for the treatment of hepatitis C infection (HCV).
Their publication coincides with the availability of more effective and safer oral HCV medicines, along with the promise of even more new medicines in the next few years. The guidelines are intended for use in low- and middle-income countries that are developing screening and treatment programs for individuals infected with HCV.
The new guidelines include approaches to increase the number of people screened for HCV, advice on how to mitigate liver damage for those who are infected and how to select and provide appropriate treatments for chronic HCV. WHO also evaluated certain treatment options, such as treatment with pegylated interferon, ribavirin, telaprevir and boceprevir as well as sofosbuvir and simeprevir.
WHO produced their guidelines following the standard process, which requires assessment of cost and resource implications as well as evaluation of benefits and harms of screening and treatment options. While treatment with new oral agents such as sofosbuvir and simeprevir is recommended, WHO noted that its recommendation was made without taking resource use into consideration as pricing information was not available for most of the countries. As new oral agents become available in more countries, future WHO guidelines will likely consider the pricing information.
While international guideline developers have considered cost and economic value in making recommendations, U.S guideline developers have recently been encouraged to consider cost and value in their evidence assessments. There has been a trend that private payers use international guidelines (e.g., NICE) to inform their coverage decisions especially around the issue of resource implications. While the WHO targets their guidelines towards low- to middle-income countries, the cost considerations are relevant to the U.S market given significant focus on increasing the value of healthcare.
WHO will update their hepatitis C guidelines periodically as new compounds become available.
View WHO’s guidelines.