Victrelis vs Incivek

[doncheery]

I am Canadian. Victrelis has been cleared for use in Canada. Incivek has not. Cost for Victrelis is 2000. a week. Soon to be cleared for Medicare ( free ) early in new year or so I have been told. Most posts that I read here involving triple treatment seem to be Incivek. Is one more effective than other? Side effects?  Thank yo in advance for any info.

[willbb]

Thx.for posting that....faster than we all thought...very good news.

Will

[doncheery]

Her is the Financial Post full article on the release
http://www.financialpost.com/markets/news/Health+Canada+Approves+INCIVEK+telaprevir+People+With+Hepatitis/5288103/story.html

[doncheery]

Good news indeed for Canadians. . The above link is a stock report. It occurred to me that I might invest in Victrelis and Incivek. The black humor of making money off my liver appeals to me.  

[Trish77]

That's good news. I didn't think it was going to happen so quickly. Thanks for posting.

[penn1023]

Vertex approved in Canada
http://www.zacks.com/stock/news/59513/Vertex's+Incivek+Approved+in+Canada

[willing]

sorry about the rash.. It helps to do one's homework up front so one can be clear about one's choice when dealing with the rx request. My Dr. was also leaning towards inci but agreed to my request for vic. Most Drs will likely go along with an explicit  request.

The difference in sx and in PI duration are two of the most important considerations.

Unfortunately there is not yet much reliable data comparing effectiveness of the two, and the vendor marketing data is not trustworthy.  For example the following review puts the overall inci effectiveness among naives at about 70%:
http://www.ncbi.nlm.nih.gov/pubmed/21558488

However naives are such a diverse group they are not well suited for ferreting out small differences in drug effetiveness. A better comparison comes from seeing how the two Pis  fared among patients with very similar response patterns (eg relapsers who cleared after 4w of PI) and there the numbers are very close.

[scoleman]

I haven't seen anything about success rates on Victrelis vs Incivek in this thread.  I wanted to go on Victrelis and avoid the probable side effect of rashes.  My US doc was insistent on using Incivek because it has an 80% SVR compared to 70% for Victrelis.

I'm now on Incivek and learning how to deal with rash.

Good luck.

[Trish77]

That's a fascinating web link - thanks!  For the record, we did follow the steps listed when I was first turned down for provincial coverage for treatment drugs and it resulted in two denials and got me nowhere.  My next set of doctors felt they would be able to get it approved however and then I ended up in a trial so it was moot.  Anyway......  

Followed some of the links out of pure interest and ended up locating the DIN numbers for Victrelis.  There are a number of them, didn't have time to go through them to sort which you'd ask on but the info is here.  Should be able to check with your insurance company if they've got this listed and a coverage rate set for it.

http://webprod3.hc-sc.gc.ca/dpd-bdpp/dispatch-repartition.do?lang=eng

[doncheery]

ugh spelling. Meant Victrelis

[doncheery]

Thanks Trish
That was a great link. I did not realize that Victrekis was cleared for use as recently as 3rd Aug/2011.
VICTRELIS™ Approved in Canada: First in new class of drugs to significantly improve clearance of chronic hepatitis C virus from the body

MONTREAL, Aug. 3, 2011 /CNW/ - Merck announced today that VICTRELIS™ (boceprevir) has been approved in Canada for the treatment of chronic hepatitis C (CHC) genotype 1 infection in combination with the current standard therapy, peginterferon alpha and ribavirin (peg/riba), in adult patients (18 years and older) with compensated liver disease, including cirrhosis, who are previously untreated or who have failed previous therapy.1

Reading the press release a light bulb went off. I know some of the Merck people socially. Sales reps. Our offices very close. and have known them for years. Maybe a good source of info re Canadian Medicare . . Montreal is a hub for big pharma. I will be pulling all strings that I can informational and personal .

Following is a good link for Canadians who feel that they qualify for, or are in need of Victrelis  and believe it is unavailable due to cost at this point in time. ( cost listed on Merck site is 1050.00 list price per week.
http://www.drugcoverage.ca/p_rejected_claims.asp

[Trish77]

An article of interest for you.

http://newswire.ca/en/releases/archive/August2011/03/c8841.html

There's a contact number there for Merck that looks like a PQ #, for what it's worth.  Can ask about patient assistance plans in Canada for starters.

It does say Victrelis is available and has a list price so perhaps if you can get a DIN number for it, you can call your insurance company and ask what their coverage is.  Already some private insurers in the U.S. are rating this drug at 50% co-pay so it's possible private insurers in Canada may follow suit.

As for what provincial drug plans will do - that's going to be the interesting question.  Provincial drug plans in Ontario won't cover drugs for anyone in Stage 1 unless the doctor really goes to bat for it and it still may not be covered.  So it depends on how much bang for the buck the government medical advisors seem to think it is and for whom.  It will be interesting to see which way this goes.

Whomever starts down the Victrelis path in Canada will be our pioneers in this so hope you'll post what you learn as you go along.

[doncheery]

I gather whether Quebec or Ont it is a variation on theme. Both wife and I have work related private insurance yet do not believe they cover the full pop for a drug like this. meh..we'll see in new Year as that is when I am supposed to begin also. Good Luck to us.

[willbb]

To be honest I have not looked into the actual availability of Vic . yet as I will not be treating until at the earliest next year. so I am not yet familiar with the  private insur.co. stance on the coverages yet.
Were I am in Ont. it would be the trillium f oundation(Ont. govt.) that  assists patients that do not have private insur. and I have not spoken with anyone there yet either.
I believe you are in Quebec  and I am sorry I have no idea how the health benefits work in that province....possibly someone else can be a little more help in that regard.

Best to you..
Will

[spectda]

"*TREATMENT FUTILITY (for victrelis)
If the patient has HCV-RNA results greater than or equal to 100 IU/mL at TW12, then discontinue three-medicine regimen. If the patient has confirmed, detectable HCV-RNA at TW24, then discontinue three-medicine regimen.
†In clinical trials, HCV-RNA in plasma was measured using a Roche COBAS® TaqMan® assay with a lower limit of quantification of 25 IU/mL and a limit of detection of 9.3 IU/mL. See Warnings and Precautions (5.5) for a description of HCV-RNA assay recommendations."

[doncheery]

Re Incivek available mid to early 2012...available but Medicare?  I gather from one conversation with my Hep Dr that the situation with Vic is that it is available but only private. She assures me that it will be Medicare available early 2012. Remains to be seen. I have searched net for confirmation of this but have not found anything. If you have any directions or info regarding Victrelis and medicare availabilty it would be appreciated. Even anecdotal. Thanks for posting reply.

[willbb]

To maybe simplify things a little ..the dosing for Vic for someone who has never treated before (naives) is:

A 4 week lead in with INF/PEG....then start VIC and if  UND.at wk8 and still UND. at Wk24 do another 4 weeks of all three for a total of 28 weeks

If still DET.at wk 8  and Und. at Wk.24 then do all three for another 32 weeks...stop Vic and do just INF./Riba for another 12   for a total of 48.

So your status at the 8 week mark is very important

Also a did hear at the liver clinic I attend in T.O that Inci will be here sometime in early to mid 2012  if waiting is an option for you

Good luck

Will

[doncheery]

Thanks lynda.  Info was informative to the point of overwhelming. What I did get out of it as you pointed out was a clearer picture regarding side effects,  SVR rates, side effects  and duration.
As to which is more effective Vic or Incivek ,beyond my comprehension and frankly irrelevant as if I am eligible it will be Vic or nothing., as I previously stated Incivek is not available in Canada.
One thing that did take me aback was the prescribing time. Unless I read wrong it is still a 48 week treatment with Vic not involved in all 48 weeks. I have to go back and check when off work and take notes. Once again thank you you for pointing me in right direction. Take Care

[lynda607]

Here is the prescribing information issued by Vertex (Incivek) and Merck (Victrelis).  Both contain SVR rates according to trial results, side effects, prescribing information, contradictions, treatment duration, etc.

http://pi.vrtx.com/files/uspi_telaprevir.pdf
http://www.merck.com/product/usa/pi_circulars/v/victrelis/victrelis_pi.pdf