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abksmin 1 post  |  Last Activity: Dec 20, 2014 11:30 AM Member since: May 2, 2002
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  • abksmin abksmin Dec 20, 2014 11:30 AM Flag

    Harvoni is the comparator against Viekira. Requires no ribavirin or interferon. You need to wake-up. Viekira is approved for mild compensated cirrhosis (Child Pugh A) only, not recommended for Child Pugh B and contraindicated for Child Pugh C, no question about use for decompensated cirrhosis. Harvoni is approved for compensated cirrhosis Child Pugh A, B or C without need for dose adjustment. This says a lot about safety. No requirement for ribavirin as it does not increase SVR 12, adds hemato-toxicity only. Harvoni is so safe that it is approved for compassionate use in EU for decompensated cirrhosis awaiting transplant to reduce possibility of death. The only differentiation for Viekira is in GT 1b cirrhotic patients, of which there are few in the US as more GT 1a, and here, Viekira with ribavirin for 12 weeks is the Abbvie regimen, while 24 weeks if the Gilead regimen without ribavirin. So even here, it is not a clear win for Viekira. The average cost for Harvoni considering 8 weeks treatment for GT 1 naïve and 12 weeks for GT 1 experienced/difficult, the cost of Harvoni is $ 84,000, there is no ribavirin used with Haarvoni, a single pill per day. Viekira cannot be used for 8 weeks and in most patients, needs to be used with ribabvirin adding $ 6000 to the cost (Moderiba is the Abbvie version). Add in the cost of Moderiba and you get a cost of $ 89,000 and the patient has to take multiple pills twice a day. Counter this with one point in favor of Viekira if you can ?

    Sentiment: Hold

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