1 Recommendations

1.1 Sofosbuvir–velpatasvir is recommended as an option for treating chronic hepatitis C in adults, as specified in table 1, only if the company provides the drug with the discount agreed in the simple discount agreement.

Table 1 Sofosbuvir–velpatasvir for treating chronic hepatitis C in adults

HCV genotype	Liver disease stage	Treatment	Recommendation according to treatment history
			Untreated		Treated
1	With or without compensated cirrhosis	Sofosbuvir–velpatasvir	Recommended
2	Without cirrhosis	Sofosbuvir–velpatasvir	Recommended only for people who cannot tolerate interferon or it is not suitable for them	Recommended
	Compensated cirrhosis	Sofosbuvir–velpatasvir	Recommended
3	Without cirrhosis	Sofosbuvir–velpatasvir	Recommended
	Compensated cirrhosis	Sofosbuvir–velpatasvir (with or without ribavirin)	Recommended
4	With or without compensated cirrhosis	Sofosbuvir–velpatasvir	Recommended
5	With or without compensated cirrhosis	Sofosbuvir–velpatasvir	Recommended
6	With or without compensated cirrhosis	Sofosbuvir–velpatasvir	Recommended
1–6	Decompensated cirrhosis	Sofosbuvir–velpatasvir (with ribavirin)	Recommended
Abbreviation: HCV, hepatitis C virus. Treated – the person's hepatitis C has not adequately responded to interferon-based treatment.

1.2 It is recommended that the decision to treat and prescribing decisions are made by multidisciplinary teams in the operational delivery networks put in place by NHS England, to prioritise treatment for people with the highest unmet clinical need.

1.3 This guidance is not intended to affect the position of patients whose treatment with sofosbuvir–velpatasvir was started within the NHS before this guidance was published. Treatment of those patients may continue without change to whatever funding arrangements were in place for them before this guidance was published until they and their NHS clinician consider it appropriate to stop.