Egypt has the highest hepatitis C burden in the world, with some 14.7% of Egyptians testing positive for HCV antibody. Therefore, it was no surprise that news of the latest oral HCV treatments approved by the FDA in the United States generated quite a buzz in local Egyptian media. The new drugs are very effective and have nearly no side effects, unlike the current regimens that cause depression, anaemia and severe nausea and do not have high success rates.
However, Raymond Schinazi, an Italian-Egyptian pharmacologist who oversaw the development of the new antiviral sofosbuvir which has generated excitement, warned that Egyptians should not be rejoicing just yet, in an interview with the Al-Ahram daily.
The new drug might be too expensive for developing countries, he warns. A 12-week treatment regimen could cost US$86,000 – which is far well more than 0.5 million EGP – much more than most people can afford. With the large number of people needing treatment, it would be impossible for the government to use the new drug instead of its current regimen, in which a full, 48-week course of HCV medication using the antiviral drug ribavirin and interferon costs around US$3,500.
“The drug can save the lives of millions around the world. But at its current price, it can bankrupt developing countries,” Schinazi tells Al-Ahram.
He goes on to stress that most of the studies conducted on sofosbuvir were on genotype 1, which is the genotype most present in North America and Europe. However, it has not been widely tested against genotype 4 which is the predominant one in Egypt and the Middle East.
“The cost of treatment will eventually go down, similar to what happened with antiretroviral treatments for HIV/AIDS. However, I think it may still be a huge burden for Egypt due to the large number of people infected with the virus,” adds Schinazi in his interview.
He goes on to suggest that a more reliable strategy for Egypt would be to invest in medical and pharmacological research and develop it’s own affordable drugs, similar to what countries in Southeast Asia have done. “You spend millions annually to treat a few thousand people and the infection rate is still high. This money should be better managed to improve research and raise awareness to limit new infections.”