1 Recommendations

1.1 Elbasvir–grazoprevir is recommended, within its marketing authorisation, as an option for treating genotype 1 or 4 chronic hepatitis C in adults, as specified in table 1, only if the company provides the drug at the same price or lower than that agreed with the Commercial Medicines Unit.

Table 1 Elbasvir–grazoprevir for treating chronic hepatitis C in adults

Genotype	Treatment and duration
1a	Elbasvir–grazoprevir for 12 weeks.
1a	Consider elbasvir–grazoprevir plus ribavirin for 16 weeks in people with a baseline hepatitis C virus RNA level of more than 800,000 IU/ml or specific NS5A polymorphisms causing at least a 5‑fold reduction in activity of elbasvir.
1b	Elbasvir–grazoprevir for 12 weeks.
4	Elbasvir–grazoprevir for 12 weeks.
4	Consider elbasvir‑grazoprevir plus ribavirin for 16 weeks in people with a baseline hepatitis C virus RNA level of more than 800,000 IU/ml.

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.