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Technology Guidance - Drug

Direct-acting antiviral agents for treating genotype 1 chronic hepatitis C First published on 1 October 2018

Guidance Recommendations
The Ministry of Health's Drug Advisory Committee has recommended:
  • Sofosbuvir 400 mg/velpatasvir 100 mg tablet for treating genotype 1 chronic hepatitis C infection in treatment-naïve, or pegylated interferon plus ribavirin (PR)-experienced, or NS3/4A protease inhibitor (boceprevir, simeprevir, telaprevir)-experienced adults.
Sofosbuvir/velpatasvir should be used in line with the recommended treatment regimen and duration:
  • 12 weeks' treatment of sofosbuvir/velpatasvir for patients with genotype 1 hepatitis C virus without cirrhosis or with compensated cirrhosis (Child-Pugh A)
  • 12 weeks' treatment of sofosbuvir/velpatasvir in combination with ribavirin for patients with genotype 1 hepatitis C virus with decompensated cirrhosis (Child-Pugh B or C).
Sofosbuvir/velpatasvir should be prescribed by a specialist physician (gastroenterologist, hepatologist, or infectious disease specialist) with experience in the treatment of hepatitis C.

The supplier will provide retreatment with sofosbuvir/velpatasvir/voxilaprevir to patients who fail to achieve a sustained virological response with sofosbuvir/velpatasvir through their No Cure No Pay program, at no additional cost.

Subsidy status

Sofosbuvir 400mg/velpatasvir 100 mg tablet is recommended for inclusion on the Medication Assistance Fund (MAF), for the abovementioned indication.
A clinical checklist must be completed for all patients who are prescribed sofosbuvir/velpatasvir through MAF. Clinical outcome data will also be collected by MOH for each patient after they have completed their treatment course.
MAF assistance does not apply to other direct-acting antivirals (asunaprevir, ombitasvir/paritaprevir/ritonavir+dasabuvir, sofosbuvir/ledipasvir, elbasvir/grazoprevir and daclatasvir).

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