Participating Faculty: Manging the Hepatitis C Virus

This supplement to The American Journal of Managed Care reviews the clinical and economic burden of HCV infection and current therapies for HCV infection, describes challenges for managed care organizations and the cost-effectiveness of HCV infection treatment, and discusses upcoming and future therapies.

Faculty

Bruce R. Bacon, MD

Professor of Internal Medicine

Saint Louis University School of Medicine

St Louis, Missouri

Vandana Khungar, MD, MSc

Department of Medicine

Cedars-Sinai Medical Center

Los Angeles, California

Fred Poordad, MD

Department of Medicine

Cedars Sinai Medical Center

Los Angeles, California

Eugene R. Schiff, MD, MACP, FRCP, MACG, AGAF

Professor of Medicine

Director, Schiff Liver Institute/Center for Liver Diseases

University of Miami Miller School of Medicine

Miami, Florida

Faculty Disclosures

These faculty have disclosed the following relevant commercial financial relationships or affiliations in the past 12 months.

Bruce R. Bacon, MD

Consultant/advisory board: Gilead, Merck, Romark Laboratories, Three Rivers Pharmaceuticals, Vertex

Data and safety monitoring board: Gilead, Isis, Vertex

Grants: Bristol-Myers Squibb, Gilead, Merck, Roche Laboratories, Romark Laboratories, Three Rivers Pharmaceuticals, Vertex, Wyeth

Speakers’ bureau: Gilead, Merck, Three Rivers Pharmaceuticals

Vandana Khungar, MD, MSc, has nothing to disclose.

Fred Poordad, MD

Consultant/advisory board: Abbott, Achillion, Anadys, Gilead, Merck, Novartis, Pfizer, Vertex

Grants: Abbott, Achillion, Anadys, Bristol-Myers Squibb, Gilead, Merck, Novartis, Pfizer, Pharmasset, Vertex

Speakers’ bureau: Gilead, Roche, Vertex

Eugene R. Schiff, MD, MACP, FRCP, MACG, AGAF

Scientific advisory board: Bristol-Myers Squibb, Gilead, GlobeImmune, Johnson & Johnson, Merck, Roche Molecular, Schering-Plough, Vertex

Data and safety monitoring board: Daiichi-Sankyo, Johnson & Johnson, Pfizer, Salix Pharmaceuticals, sanofi-aventis

Grants: Abbott, Anadys, Bristol-Myers Squibb, Gilead, GlobeImmune, Medtronic, Merck, Roche Diagnostics, Roche Molecular, Salix Pharmaceuticals, sanofi-aventis, Schering-Plough, SciClone Pharmaceuticals, Vertex

The planning staff from the University of Cincinnati, The American Journal of Managed Care, and the Pharmacy Times Office of Continuing Professional Education have no relevant financial relationships to disclose.

The contents of this supplement may include information regarding the use of products that may be inconsistent with or outside the approved labeling for these products in the United States. Physicians should note that the use of these products outside current approved labeling is considered experimental and are advised to consult prescribing information for these products.

Disclosure Policy

According to the disclosure policies of the University of Cincinnati and Pharmacy Times Office of Continuing Professional Education, faculty, editors, managers, and other individuals who are in a position to control content are required to disclose any relevant financial relationships with relevant commercial companies related to this activity. All relevant conflicts of interest that are identified are reviewed for potential conflicts of interest. If a conflict is identified, it is the responsibility of the University of Cincinnati and Pharmacy Times Office of Continuing Professional Education to initiate a mechanism to resolve the conflict(s). The existence of these interests or relationships is not viewed as implying bias or decreasing the value of the presentation. All educational materials are reviewed for fair balance, scientific objectivity of studies reported, and levels of evidence.

Signed disclosures are on file at the office of The American Journal of Managed Care, Plainsboro, New Jersey.

Managing the Hepatitis C Virus: Challenges and Opportunities for Managed Care

Release date: March 28, 2011

Expiration date: March 28, 2012

Estimated time to complete activity: 2.5 hours

This activity is supported by an educational grant from Merck & Co, Inc.

Intended Audience

The audience for this supplement consists of medical directors, pharmacy directors, and other managed care professionals who oversee the care of patients with hepatitis C virus (HCV) infection.

Statement of Educational Need/Program Overview

HCV infection is a major, chronic health problem. HCV infection complications include fibrosis, cirrhosis, and hepatocellular carcinoma, and it is the leading cause of end stage liver disease requiring transplantation in the United States. Modeling studies have shown that morbidity and mortality due to HCV infection are expected to double or even triple over the next 2 decades, leading to a dramatic rise in the burden associated with the disease.

The primary goal of treating HCV infection is prevention of HCV-related complications and death, but the therapeutic goal is achieving a sustained virologic response. Several knowledge, performance, and outcomes gaps, however, exist which prevent clinicians from being able to achieve this goal, including only moderate or suboptimal responses to current standard therapies and treatment-related adverse events.

Addressing these gaps is necessary to improve HCV infection management and outcomes. Introduction of the protease inhibitors telaprevir and boceprevir is expected to make a significant impact on sustained virologic response rates. Other therapies in development, such as nucleoside inhibitors, non-nucleoside inhibitors, NS5A inhibitors, directly acting antiviral combinations, therapeutic vaccines, human monoclonal antibodies, and immune modifiers hold promise in the treatment of HCV infection.

This educational activity will inform managed care professionals about the clinical and economic burden of HCV infection and current therapies for HCV infection, describe challenges for managed care organizations and the cost-effectiveness of HCV infection treatment, and discuss upcoming and future therapies.

Educational Objectives

After completing this activity, the participant should be better able to:

• Describe the burden associated with HCV infection
• Evaluate the efficacy of standard-of-care therapies in the management of HCV infection and efforts to optimize viral eradication in HCV-infected patients, thereby reducing disease burden
• Identify predictors of treatment outcomes, including the impact of genotype and adherence, to select and apply strategies to improve treatment response
• Assess the potential of emerging HCV infection therapeutic strategies for improving treatment response and outcomes in HCV-infected patients, including available efficacy and safety data

Physician Continuing Medical Education

Accreditation Statement

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the University of Cincinnati. The University of Cincinnati is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation

The University of Cincinnati designates this enduring material activity for a maximum of 2.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Pharmacist Continuing Education

Accreditation Statement

Pharmacy Times Office of Continuing Professional Education is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This program is approved for 2.5 contact hours (0.25 CEUs) under the ACPE universal program number of 0290-9999-11-016-H01-P. This program is available for CE credit through March 28, 2012.

The contents of this supplement may include information regarding the use of products that may be inconsistent with or outside the approved labeling for these products in the United States. Physicians should note that the use of these products outside current approved labeling is considered experimental and are advised to consult prescribing information for these products.

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