Prevalence of the hepatitis C virus (HCV) in Brazil is estimated to be among the highest in the world; in addition, the country faces the challenge of treating a largely undiagnosed HCV-infected population. Chronic HCV infections are often asymptomatic for years, which is a key barrier to diagnosis and treatment. Further, the lack of timely treatment can increase the risk of severe liver complications such as cirrhosis and hepatocellular carcinoma. The primary goal of HCV treatment is to completely eliminate the virus from the patient’s body and thereby reduce or halt the progression of liver disease. Currently, the standard of care for chronic HCV infections in Brazil is a lengthy treatment course of pegylated-interferon -alpha (peg-IFN-?; Roche’s Pegasys or Merck’s PegIntron) plus ribavirin (Roche’s Copegus, Merck’s Rebetol, generics) or telaprevir- (Johnson & Johnson’s Incivo) or boceprevir- (Merck’s Victrelis) based triple therapy. The imminent approval and launch of follow-on direct-acting agents (e.g., Gilead’s sofosbuvir, Janssen/Medivir’s simeprevir, Bristol-Myers Squibb’s daclatasvir) is set to trigger a major shift in the treatment paradigm with the introduction of interferon-free therapy in Brazil; this market change is poised to drive an increase in treatment rates in this key emerging market.

Questions Answered in This Report:

  • The number of HCV seroprevalent cases in Brazil will increase over the 2013-2023 forecast period, mainly in the 40+ age cohort. What is the seroprevalence of HCV, and what is the proportion of viremic cases in Brazil? What are the predominant genotypes encountered in Brazil? What percentage of patients are treatment-naive versus treatment-experienced by cirrhosis status? How has the number of diagnosed HCV cases changed in the past two years? What factors are improving diagnosis in Brazil?

  • Interferon-based dual and triple therapy is the standard of care for HCV patients in Brazil, but physicians are warehousing in anticipation of interferon-free treatments. What are the factors driving Brazilian physicians’ prescribing habits in relation to HCV therapies? What are the leading comorbid conditions among HCV patients in Brazil? Do physicians follow treatment guidelines and clinical protocols? What are the key factors that limit treatment of patients or influence warehousing of patients? What are the average cure rates achieved with current treatment options and the discontinuation rates linked to these therapies? What are the leading prescribing choices by genotype, prior treatment status, cirrhosis status, and type of health plan (public vs. private health plans)?

  • Emerging therapies are expected to shift the treatment landscape in Brazil. What is the level of physician awareness of emerging therapies? Do physicians expect these regimens to launch in Brazil? To what extent do physicians expect to use these emerging therapies (physician-reported anticipated patient shares)? Which regimen will emerge as the leading treatment option in 2018? How will the availability of new treatments impact treatment rates? What will be the impact on drug treatment rates?

Scope:

Markets covered: Brazil.

Primary research: 30 infectious disease (ID) specialists, 30 gastroenterologists, and 30 hepatologists participated in an online survey; 8 HCV experts were interviewed for this study.

Epidemiology: Seroprevalence of HCV.

Emerging therapies: Phase III: 12 drugs.

Author(s):