Twenty-nine-year-old Imran Mohammad's composure defies the fact that he is suffering from a double whammy of thallasemia and, subsequently, viral hepatitis for many years now. Imran got infected with Hepatitis C because of faulty blood transfusion. Since then, he has been trying to make ends meet to buy expensive medication to manage both disorders.
"I have to take iron chellator injections every night, each injection is worth Rs14,000 for reducing the iron overload on my liver after weekly blood transfusions. In the process, when I discovered that I was infected with Hepatitis C, I was shattered," he said.
While thallasemia is a disorder where a faulty gene affects the body's capacity to produce haemoglobin, Hepatitis C is a viral condition spread through infected blood, needles, tattooing, surgery or intravenous drip and affects the liver.
Two new drugs on the block, Sofosbuvir and Simepravir, approved by the US-FDA in 2013, which, doctors say, cure 90% of Hepatitis C cases, are exorbitantly priced at Rs1.8 crore for a six-month treatment. Imran sees little hope in getting himself cured as, he said, he can't afford the additional expenses of Hepatitis C drugs.
A month ago, CLF and Think Foundation had petitioned to Union health minister Dr Harshvardhan for making these drugs available for less price in India. Alternatively, the petition also suggested that Indian pharmaceutical companies should be engaged to produce cheaper variants of the expensive drugs currently manufactured by multinational companies Johnson & Johnson and Gilead.
"Recently, a group of oral drugs, Directly Acting Antivirals have been reported to show 90% cure rates. They are commercially available in the West. Priced at Rs60,000 per tablet, a six-month course will cost over Rs1 crore. These drugs may be available in India by the end of 2015," said Dr Aabha Nagral, founder trustee, Children's Liver Foundation (CLF).
In India, 1.2 crore people are estimated to have been infected with Hepatitis C. "Nearly 80% of these develop chronic hepatitis with damaged liver and symptoms of tiredness and weakness, and 20%, over a few years, will go on to develop fatal liver cirrhosis or damage and 5% suffer from liver cancer. In spite of such severe repercussions, drugs to treat the condition are anything but affordable," Nagral said.
A joint study by CLF and Think Foundation that observed 3,100 thallasemia patients in five centres of Mumbai revealed that 10% of these patients were reeling under the burden of Hepatitis C virus. Experts said this is an extremely high load considering that the situation is completely avoidable.
"In addition to making drugs affordable, state should ensure that safe blood is being transfused. Currently, there is a window period of close to two months between testing the blood and manifestation of the virus in the sample. Before the window period expires, blood is transfused in an unsuspecting patient. A nucleic acid test (NAT) needs to be introduced across all labs to prevent infections. NAT reduces the window period revelation to one week," said Vinay Shetty, vice-president, Think Foundation.
About the condition
Hepatitis C is a viral disease spread through infected blood, needles, tattooing, surgery or intravenous drip. Two new drugs, approved by US-FDA in 2013, Sofosbuvir and Simepravir, which are directly acting antivirals, are priced at Rs60,000 per tablet — a six-month course will cost Rs1.8 crore. CLF and Think Foundation have petitioned Union health minister Dr Harshvardhan for making these drugs available for less price in India
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