New drug gives patients hope
By Hu Yan (China Daily)
Updated: 2005-11-18 06:13

SAN FRANCISCO: Medical experts at a global conference have received encouraging news about new treatments for hepatitis B.

But the fight against the China's leading infectious disease, which kills half-a-million people on the Chinese mainland each year, is being complicated by the high cost of treatment, public misunderstanding of the disease and quack therapies.

At least one of the new research studies presented at the 56th Annual Meeting of the American Association for the study of Liver Disease, running from November 11 to 15 (San Francisco Time) with some 5,500 participants, looks promising.

A phase-III global clinical trial of telbivudine, an oral anti-viral drug, has shown the new treatment to be more effective at suppressing hepatitis B virus than the current standard anti-viral drug, lamivudine.

Around 95 per cent of the 1,367 patients in 20 countries, including China, that took part in the trial, showed no further symptoms of the disease after one year.

Ching-Lung Lai, a professor at the University of Hong Kong and a leading researcher on the study, said research indicated telbivudine had the potential to reduce serious complications associated with chronic hepatitis B and promised a safer option for patients.

The new drug, developed under collaboration between Novartis AG and Idenix Pharmaceutical Inc, will be filed to key global regulatory bodies in the United States, Europe and Asia in early 2006.

But top Novartis officials said it was too early to say how much the drug would cost, a major concern for patients around the world.

Commenting on the potential new drug, hepatitis specialists have urged pharmaceutical giants to make drugs more affordable for patients suffering from hepatitis B.

"Pharmaceutical companies need to look at the bigger picture and make it (telbivudine) available to as many people as possible," said Samuel So, director of the Asian Liver Centre at Stanford University.

Of the 350 million people worldwide who are chronically infected with hepatitis B, 75 per cent are in Asia. In China, more than 100 million people are infected with the virus that can lead to liver disease. The country has the most cases of hepatitis B and liver cancer in the world. Liver cancer is the second-most lethal cancer in China after lung cancer.

Global pharmaceutical companies, including GlaxoSmithKleine Inc and Roche AG, have introduced five anti-viral drugs to the Chinese market since 1999.

The monthly cost of such drugs varies from 468 yuan (US$57) to 5,400 yuan (US$654), but for most Chinese patients, even the cheaper drugs are too expensive.

To date, only one anti-viral drug has been covered by China's social medical insurance.

A recent survey of 400 hepatitis B patients at hospitals in six major Chinese cities found that only 19 per cent were sticking to long-term anti-viral treatments.

"Many of my patients fail to follow the treatment guidelines of taking anti-viral drugs for months or years, because they only can afford the drugs for several days or weeks.

Once they stop taking drugs, the virus returns and the disease progresses," said Wang Yuming of the LiverDisease Research Centre in Southwest China's Chongqing Municipality.

Medical experts have suggested the government reform the social medical insurance system to better address this devastating public health problem.

Wang is upset to see his patients give up their treatment because of financial problems, but he is also angered to see patients wasting money on quack treatments which result in nothing but more sickness.

An estimated 80 per cent of hepatitis B patients in China are fed false medical information: some are fooled by quick-fix treatments which claim they can "cure hepatitis B within a couple of months," others believe unproven herbal remedies can cure them, and some visit unqualified back-street clinics because they are ashamed of the disease and want to avoid the social stigma attached to hepatitis B.

Public health experts say that once hepatitis B develops into liver cancer or other more serious conditions, medical costs rocket. In the long run, treating the disease early is the cheapest option. To get this message across requires the education of patients and the improved training of doctors.

"Doctors need to better communicate with patients, informing them that the treatment of hepatitis B is a long process, and the correct course of action is to contain the virus and prevent it from developing into liver cancer," said Hou Jinlin from the Hepatology Unit and Department of Infectious Diseases at Southern Medical University in Guangzhou, South China's Guangdong Province.

Experts from the Chinese Society of Infectious and Parasitic Diseases suggest professional standards or a specialist licence should be established for doctors treating hepatitis B.

This could change the current chaotic situation in which many Chinese doctors, especially those in community healthcare centres, lack the necessary medical knowledge.

(China Daily 11/18/2005 page5)