New treatment to overcome drug resistant hepatitis B

PHARMAC is investing in a new medication to help overcome drug resistance for people with hepatitis B.

From August 1, entecavir (Baraclude) will be funded under Special Authority as a first line treatment option for people with hepatitis B.

Hepatitis B is a viral infection that can cause potentially fatal liver disease. PHARMAC Medical Director Dr Peter Moodie says the currently-funded first line antiviral treatment lamivudine is initially highly effective against hepatitis B, but over time the virus mutates and lamivudine’s effectiveness reduces.

“This newly funded drug, entecavir, is also very effective in treating Hepatitis B but has much lower rates of resistance, even after four years of treatment,” he says.

Dr Moodie says funding entecavir adds to other treatment options PHARMAC has recently funded for people with hepatitis B. In April this year PHARMAC widened access to pegylated interferon alpha, adding to the existing funded treatments of interferon, lamivudine and adefovir dipivoxil.

“This latest decision to fund entecavir is yet another step forward in the range of options available for the treatment of New Zealanders with hepatitis B, and will prevent many of them from developing potentially fatal liver disease.” Dr Moodie says.

Hepatitis B infection results from exposure to infected blood or body fluids. It causes early death through liver cirrhosis, liver failure or liver cancer in up to a quarter of people infected.

In New Zealand there are about a thousand people currently receiving funded treatment for hepatitis B and infection rates are increasing. New Zealand has high rates of Hepatitis B, particularly in Maori, Pacific Island and Asian peoples.

Dr Moodie says PHARMAC expects up to 150 new patients per year will benefit from funded access to entecavir. PHARMAC negotiated the funding of entecavir as part of an agreement with pharmaceutical company Bristol-Myers Squibb.

Dr Ed Gane, hepatologist at the NZ Liver Unit in Auckland, has welcomed the decision.

“PHARMAC’s decision to fund Entecavir is welcomed by all of us who manage patients with chronic hepatitis B,” says Dr Gane. “This treatment represents a real advance in treatment of chronic hepatitis B given its improved effectiveness and safety, with virtually no risk of antiviral resistance after more than 6 years of therapy. “