Treating Hepatitis C

Treating Hepatitis C – the next phase

170 million HCV sufferers1

~20% GT2/3

~70% GT1 HCV patients

~10% GT4-6

Current treatment landscape

GT1: 40-50% SVR 48-week treatment

1999

GT1: 70-75% SVR 24-week treatment

2001

2002

2011

Pipeline therapies2 Nucleoside inhibitors

Non-Nuc inhibitors

NS5A inhibitors

“Cornerstone drugs have a high

“They are very much restricted to GT1

“NS5A inhibitors have shown promis-

“The benefit of the next wave of

but I think their potency has improved

ing efficacy and good tolerability.

protease inhibitors is not the slightly

barrier to resistance, pangenotypic efficacy and strong potency so obviously the nucs are in that class.”

Protease inhibitors

considerably - I was sceptical on

I think the only limitation of these

increased potency compared to

these drugs but now I see that there

combinations will be the safety

telaprevir and boceprevir; it is the

are clear options.”

profile.”

once-a-day pill without food without fat, without rash, without anaemia”

US Key Opinion Leader

European Key Opinion Leader

US Key Opinion Leader

European Key Opinion Leader

Development stage

Dosing

Cure rate (naïve patients)

Safety/tolerability

Sofosbuvir/GS-5885 ± RBV

Phase III

400mg/90mg QD ± 500mg BID 12-weeks

GT1:100% SVR4 GT2/3: 78% SVR12

No known issues

ABT-333 + ABT-450/r + ABT-267 + RBV

Phase III

400mg BID + 250mg/100mg QD + 25mg QD + 500mg BID 12-weeks

GT1: 98% SVR12

Many drug-to-interactions

Daclatasvir + Asunaprevir + BMS-791325 + RBV

Phase III

60mg QD + 200mg BID + 75mg BID + 500mg BID 24-weeks

GT1/4: 94% SVR12/24

No serious adverse events

BI-201127 + Faldaprevir + RBV

Phase III

600mg TID + 600mg QD + 500mg BID 28-weeks

GT1a: 43% SVR12 GT1b: 85% SVR12

Rash, jaundice & GI disorders

Mericitabine + Danoprevir/r + RBV

Phase II

1,000mg BID + 100mg BID + 500mg BID 24-weeks

GT1a: 71% SVR12 GT1b: 26% SVR12

Dose-dependent risk of liver elevations

Sovaprevir + PEG-IFN + RBV

Phase II

200/400/800mg QD + 1.5 mcg/kg QW + 500mg BID 12-weeks

GT1: 85-100% SVR4

No known issues

TMC647 + PEG-IFN + RBV

Phase II

150mg/100mg QD + 1.5 mcg/kg QW + 500mg BID 24-weeks

GT1: 81-86% SVR24

Increase in bilirubin levels

Company

Combination

Future treatment landscape3 16

Sales value ($billion)

14 12

Launch of protease inhibitorsIncivek and Victrelis

10 8

Roche, Medivir and Vertex Merck and combinations Achillion potent launch therapies launch Abbott, Bristol-Myers Squibb and Boehringer Ingelheim interferon-free combinations launch- EU and US

Sofosbuvir launches to become first oral interferon-free combination in HC

30% of diagnosed but naïve patients are warehoused awaiting oral interferon-free regimens4

Biosimilar PEG-IFN enter market

6 4 2 0 2011

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2013e

2014e

2015e

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All Contents Copyright © 2012 Doctor’s Guide Publishing Limited. All Rights Reserved 1

World Health Organisation, Hepatitis C virus, February 2011, Accessed December 2012

2

FirstWord, Therapy Trends- KOL insight: Hepatitis C, November 2012

3

FirstWord, Therapy Trends- Consensus Outlook: Hepatitis C, November 2012

4

FirstWord, Physician Views: A third of hepatitis C patients being warehoused for new treatments, December 2012

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2020e