Ukraine: Effective drugs and patient support to combat Ukraine’s hepatitis C epidemic

©Aleksandr Glyadyelov/MSF

A combination of generic drugs coupled with a comprehensive patient support model has shown promising results in a pilot project run by Doctors Without Borders/Médecins Sans Frontières (MSF) in Ukraine.

When scaled up, it can substantially accelerate hepatitis C treatment in a country where over five per cent of the population – or at least two million people – are estimated to be infected by the hepatitis C virus.

Since December 2017, MSF has used the more affordable generic versions of hepatitis C drugs daclatasvir and sofosbuvir to treat nearly 900 people in Mykolaiv region in southern Ukraine, which is estimated to have one of the highest burdens of hepatitis C infection in the country. The cure rate is over 97 per cent.

The Ukrainian Ministry of Health (MOH) has also recently procured and allocated similar drugs to distribute nationally as part of last year’s World Hepatitis Day commitment to begin scaling up hepatitis C treatment.

Hepatitis C occurs when the hepatitis C virus (HCV) infects the liver, and it can lead to cirrhosis, liver cancer and even death. Hepatitis C is curable and the standard of care worldwide has dramatically improved over recent years with the introduction of newer, more effective oral medications recommended by World Health Organization (WHO), like daclatasvir and sofosbuvir, which have very few side effects and a high cure rate.

“We are happy to see the Ministry of Health making affordable hepatitis C medication available to thousands of patients in Ukraine. The next step will be to come up with a solution to provide access to diagnosis and treatment for the millions of people who are at risk of infection throughout the country. Our experience in Mykolaiv shows that affordable and effective hepatitis C treatment models are available,” said Grigor Simonyan, MSF’s head of mission in Ukraine.

Affordable, effective generic medicines

The high price charged by pharmaceutical companies for the brand name versions of newer hepatitis C medications has been a major obstacle faced by patients and health providers in Ukraine and around the world.

When possible, MSF opts to use more affordable generic medications in order to be able to reach more patients. Over 90 per cent of the drugs used by MSF to treat hepatitis and other infectious diseases worldwide are generics. 

Generic hepatitis C drugs have the same active ingredients as the brand name medications and work the same to eliminate the virus but are much more affordable.

However, in Ukraine, recent false information campaigns about the ineffectiveness of generic hepatitis C drugs pose an obstacle to expanding affordable treatment nationwide.

“In Ukraine, people have concerns regarding the effectiveness of generics, but MSF has used generics to treat all its hepatitis C patients in Mykolaiv region. The generic drugs and the brand name have the same chemical compound, so basically they are the same drugs. The main difference is the cost,” explains Karan Kamble, MSF medical activity manager in the Mykolaiv hepatitis C project.

Patient support

In addition to these highly effective medications, MSF offers patients in the pilot project free diagnosis and treatment as well as support, health education, guidance and counselling provided by social workers and peer educators. 

“Surely, the most astonishing thing for me was that the treatment from MSF came at no cost – that’s what I liked in the first place. Secondly, I liked the patient support. A person is not just left alone with pills to take. I regularly received calls from a health promoter and social worker. Every time I came to pick up the medications, I had a conversation with a health counsellor,” said Ihor Skalko, who was cured of hepatitis C through MSF’s pilot project.

Ihor was first diagnosed with hepatitis C in 2006 and previously received treatment with older medications through a state programme, which was not successful.

“For me, recovery is the moment when you are clear of a problem that has been gnawing at you for many, many years and hasn’t allowed you to live in peace,” said Ihor.

“After my second attempt at curing hepatitis C [through the MSF programme], when I was finally told that I had completely overcome this severe illness, I was overjoyed. I felt like going out, being happy, smiling at everyone.”

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