NHS England has been accused by a charity of “abandoning” thousands of people to a potential death sentence by rationing drugs that can cure hepatitis C.



An estimated 215,000 people in the UK have chronic hepatitis C infection (160,000 in England), which new but costly drugs can cure. Addaction, a charity that helps people overcome drug and alcohol abuse, says the decision to treat 10,000 people a year is “manifestly unfair”.

Addaction is backing a judicial review application brought by another charity, the Hepatitis C Trust, over NHS England’s decision to cap the annual numbers on cost grounds.

“The decision by NHS England to limit access to treatment is manifestly unfair on a group of vulnerable people who suffer from a terrible disease,” said Simon Antrobus, chief executive of Addaction. “Those who are infected can go on to develop cirrhosis of the liver and liver cancer. Denying these people life-saving treatment is a potential death sentence for thousands.”

The new drugs, in combination with older ones, can cure hepatitis C infection. But the cost of an eight-week course of one of them – ledipasvir–sofosbuvir, sold by Gilead under the brand name Harvoni – costs £26,000 and a 12-week course is £39,000. That is before VAT and without an additional drug that may be needed, called ribavirin. Some people may need a 24-week course, costing £78,000.

The National Institute for Health and Care Excellence (Nice) has recommended treatment of people with hepatitis C with the new drugs. NHS England first asked for a three-month delay in implementing the guidelines and then capped the numbers it would treat, so that only the sickest get the drugs immediately.

“This is a terrible decision by the NHS, and it contributes to the fact that at present less than five per cent of people infected in England are accessing treatment,” said Antrobus.

“No one is denying that the NHS is under massive financial pressure, but it is both morally wrong to deny people this life-saving treatment and makes little financial sense, as the costs of treating someone with liver disease are significantly higher.”

Hepatitis C is a blood-borne infection transmitted historically through blood transfusion – although not since 1991, because of screening – as well as injecting drugs. There is a very low risk of sexual transmission. Many people in the UK do not realise they have it for years.

About 700,000 people die every year around the world from hepatitis C. In May, the World Health Assembly voted to eliminate the viral disease, which is possible because the new drugs cure 90% of those infected. However, every country is struggling with the cost.

The UK has signed up to the pledge, the Hepatitis C Trust pointed out. “It would be good to see NHS England take seriously the United Kingdom’s international commitment to tackling hepatitis C,” said its chief executive, Charles Gore.

“Around the world, countries with far fewer resources and far higher prevalence of the virus are matching their commitment with the improved diagnosis and greater treatment that is necessary to all but eliminate the virus.”

An NHS England spokesperson said: “The NHS’s single biggest new treatment investment this year is providing these high-cost treatments to thousands of people with Hep C, in accordance with Nice guidance. The NHS has successfully now treated thousands of patients with acute needs, and is now working on a phased basis to treat the far larger number of patients with chronic but not life-threatening Hep C.

“The Department of Health have been running successful competitive procurements to secure the best prices they can. As prices come down we hope in future years to be able to expand treatments even further within the funding available, and the industry is now engaging in the discussions with us about how best to do this.”