Glecaprevir–pibrentasvir for treating chronic hepatitis C

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

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.

Why the committee made these recommendations

Current treatment options for chronic hepatitis C depend on genotype, cirrhosis status and treatment history. Glecaprevir–pibrentasvir is suitable for all genotypes and has a shorter treatment duration than most other direct-acting antiviral treatments.

Clinical trials show that glecaprevir–pibrentasvir is effective for treating chronic hepatitis C across all genotypes. There was only 1 trial directly comparing glecaprevir–pibrentasvir with other direct-acting antiviral regimens, but comparing individual arms of clinical trials of other direct-acting antivirals suggests that glecaprevir–pibrentasvir works as well as most direct-acting antiviral drugs that NICE already recommends for treating hepatitis C.

The analysis shows that cost-effectiveness estimates for glecaprevir–pibrentasvir across all populations are substantially below what NICE usually considers acceptable. It is therefore recommended for treating chronic hepatitis C.