The Federal Food and Drug Administration has approved Gilead’s new hepatitis C medication, Epclusa, the first pill to treat all major forms of HCV. While a series of new drugs have reshaped treatment of the liver-destroying virus, they’ve been limited to single strains of the virus. For example, Gilead’s Harvoni is only approved to treat HCV genotype 1. Sure, that’s the most common type of hep C, but that treatment wouldn’t work for everyone. On the hand, Epculsa — a combo of 400 mg. of sofosbuvir and 100 mg. of velpatasvir — will.
Another advantage is that unlike other hep C treatments like Copegus and Harvoni, Epculsa doesn’t include ribavirin, an antiviral ingredient that’s poorly tolerated by some users and can come with a long list of unpleasant side effects, including abnormal breakdown of red blood cells that can lead to a heart attack. The FDA approved Epculsa for people with or without liver damage. The new drug’s broad application and lower price tag — it’s cheaper than Harvoni and Sovaldi, but not Zepatier — could make it easier to use than the other hepatitis drugs recently approved, which are each tailored to different viral strains or stages of liver disease.
With 53 million worldwide living with HCV, there is a huge market for a drug like Epculsa. As long as liver disease remains the leading cause of non-AIDS-related deaths among people with HIV, that market will also include many living with both HIV and hep C.