Saag spoke more broadly on the issue of cost. “Even though it is certainly not the intention of the guidelines to give direction on who the payers should cover, my hope would be that over time, the cost of the medications will come down and the payers will come around to realize that severely restricting access to care by not paying for medications that are desperately needed is not a way forward or a way to serve the public,” he said.
Drug development is moving quickly, and cheaper and improved therapies may be are likely coming soon, according to Jensen.
“It may actually beneficial for patients with less severe disease to wait for better treatments,” he said, adding that approximately 30% of patients with HCV will never progress to cirrhosis, which is further justification for waiting to treat.
The panelists encouraged clinicians to evaluate each patient’s specific disease stage and risk factors before making recommendations.
The website, initially launched on Jan. 30, was developed by a panel of 27 experts in liver disease and infectious diseases and a patient advocate. It has been described as a “living document” that will be updated as frequently as possible to keep pace with ongoing advances in HCV diagnosis and therapy.
Murray noted the collaborative and evidence-based nature of the site and added that, to date, it has garnered 190,000 visits and nearly 750,000 page views have been logged.
“These numbers indicate that the site has already become a useful tool for those on the front lines of HCV treatment,” she said.
Masur said that committees and subcommittees responsible for the guidelines will continue to meet regularly to keep pace with new information from medical journals, the FDA and other relevant sources.
“The chapters which are currently on the website will be modified promptly when new information warrants an update,” he said. “New chapters will be added if information warrants a new chapter.”
Saag said that another rationale for the living document is that with so many people infected, there is going to be an increasing need for providers who are up-to-date on how to treat HCV: “There are not enough hepatologists or gastroenterologists to treat all of these patients. We hope to create enough of a workforce to get these people into care and treated and cured. It will be a tall order. These guidelines will help educate those who are experts in new and emerging trends, but also perhaps those who are new to the treatment of HCV on how to handle the number of patients coming our way.” – by Rob Volansky
Disclosure: Jensen, Masur, Saag and Thomas report no relevant financial disclosures.