NHS England Limits Hepatitis C Drug Access Due to High Costs

England’s National Health Service (NHS) is intentionally hindering access to the pricey hepatitis C drugs Sovaldi (sofosbuvir; Gilead) and Harvoni (ledipasvir/sofosbuvir; Gilead) due to worries over how it will afford them, according to an investigation in The BMJ. 

During the course of their investigation, the researchers concluded that panic over high prices and affordability led NHS to intentionally hinder access through delays, which prevented timely access to these drugs, according to a press release.

Manufactured by Gilead Sciences, the hepatitis C medications offer a cure rate of more than 90%. They are also famous for their steep prices, which average nearly $90,000 per patient in the United States.

Researchers from the University of Cambridge and the University of Bath contributed to the investigation, which found NHS interfered with the National Institute for Health and Care Excellence (NICE) process that ultimately decided to make the treatments available to the majority of patients with hepatitis C through NHS. When that effort failed, NHS defied NICE by rationing access to the medications through imposing quotas on clinical teams. 

“I think some people in NHS England would love to clip NICE’s wings and turn it into a kind of recommendatory rather than mandatory body,” Andrew Ustianowski, FRCP, PhD, an infectious diseases consultant at Pennine Acute Hospitals NHS Trust, said in a press release. “And if you are going to choose a fight, then choosing this battlefield is quite a sensible thing to do — a marginalized population, very high-cost drugs.” 

NHS England’s attempts to delay access to the hepatitis C treatments led Dr Ustianowski to resign from its clinical advisory group.

“I didn’t want to be associated with what was happening,” he said in the press release.

Patients frustrated by treatment delays are turning to overseas buyer’s clubs to purchase the medications at their own expense, according to the investigation. NHS says its delivery of the drugs fits within the parameters of NICE guidance and emphasized Gilead Sciences’ high prices as the main cause of delays. 

Hepatitis C Trust, a patient advocacy group,  threatened legal action against NHS for rationing the drug.

According to chief executive Charles Gore, the trust “has already spoken to solicitors to take on any cases that come up because we are not going to have NHS England pick on a disenfranchised group.”—Jolynn Tumolo