As most people now know Gilead has launched its pan-genotype combination Epclusa, which is the combination of Sofosbuvir + Velpatasvir. With its usual eye on the market place Gilead launched Epclusa with plenty of promotions and advertising however the reality of Epclusa is that it is just another expensive and overpriced medicine that Gilead will use to squeeze more money out of the global health care system.
Of course there are fantastic advantages in have a Hep C drug that will cure across all genotypes. Gilead recognised this and the money to be made.
Firstly research has shown that about 10% of people who have Hep C are infected with more than one genotype. That means that if you treat with Harvoni for G1 and you are infected also with G2 or G3 then it is likely that you will get rid of the G1 virus but not the other viruses, against which Harvoni is not very effective.
So for the 10% of people with two virus types a pan-genotype treatment is great news.
However the reality is that Sofosbuvir + Daclatasvir is just as effective as a pan-Genotype Hep C treatment as Epclusa... and a LOT cheaper!
Sofosbuvir+Daclatasvir has one other advantage over Epclusa, that is that the active ingredients are very soluble and easy for the body to absorb. Whereas the Velpatasvir in Epclusa is highly insoluble.
The next good thing about having a pan-genotype Hep C treatment is that it removes the need for a genotype test.
Now for people in wealthy countries with national health services or insurance this is not an issue but for people in poorer countries the cost of a genotype test may be more than one months wages. So if this can be avoided it is a big saving.
So both Epclusa and the Sof+ Daclatasvir treatments offer similar great advantages for people with Hep C however the big difference between Epclusa and Sofosbuvir + Daclatasvir as a treatment option for Hep C is that Epclusa costs about US$80,000 for a 12 week treatment whilst Sofosbuvir + Daclatasvir cost about US$1,100 for a 12 week treatment.
Both a great pan-genotype treatments for Hep C offering almost identical cure rates for all genotypes but one is offered by a company that is famous for ripping off sick people and the other is affordable and is offering hope to sick people.