b'Working Together: How the VA and Industry Beat HCV in Five YearsWASHINGTONTheVAseliminationof chronic hepatitis C (HCV) infections in veterans ranks as one of the great public health success stories of the past decade. Many factors enabled this extraordinary victory, including the nature of the VA, the timing of a cure, the commitment ofleadership,supportinCongressandthe flexibility of industry partners. Asthenationslargestintegratedhealthcare system, the VA has the power to lead and transform careinAmerica.Thedepartmentsabilityto internally conduct research on a massive scale is unmatched. Its weight in the market has no equal. Critically, VA has more patients with, well, just about any condition. In 2015, it provided care for nearly 175,000 veterans with HCV.AlthoughHCVinfectedmillionsof Americansthroughbloodtransfusionsand other exposures to infected blood for decades, it was known as non-A, non-B hepatitis until With new highly effective medications able to cure hepatitis C in 95 percent of veterans 1989.Fromthestart,identifyingthevirus,who take them, the VA has sought to treat as many patients as possible with HCV. In 2018, developing a screening test, demonstrating itsDarrell A. Mason Sr. (center), a patient at the Edward Hines Jr. VA Hospital in Chicago, transmissibility in blood and documenting thatbecame the 100,000th veterans treated for HCV. The program has continued since then. itcausedhepatitisrequiredapublic-privatePhoto from April 2, 2018, VAntage Point blog.collaborationoneexplicitlyrecognized when scientists at Chiron Corp., the NationalWithin two years of its discovery, the U.S. Food and Institutes of Health and Rockefeller University in NewDrugAdministrationapprovedthefirsttreatmentfor York jointly received the Nobel Prize in Physiology orHCV, interferon alpha-2B, but it had only a 6% cure rate. Medicine for their breakthrough research on HCV inCombining ribavirin with pegylated interferon improved October 2020.results,butthenearlyyear-longdurationoftherapy andchallengingsideeffectsresultedinhighratesof discontinuation among veterans. All the manufacturers of HCVStartingin2011,however,thetreatmentforHCV therapiesGilead, Merck, AbbVie,evolved rapidly. The addition of protease inhibitors to the combination therapy resulted in an approximately 70% Janssen, Bristol-Meyers Squibb cure rate, which rose to 90% as direct-acting antivirals worked with the VA to developimproved.In2014,thefirstall-oral,interferon-free treatment emerged, offering greater than 90% of patients pricing that enabled treatment ofsustained virologic response with eight to 24 weeks of all veterans. By 2016, the VA wastreatment. By 2015, the cure rate reached 95% for most patients on a well-tolerated single combination pill, taken paying about 40% of list price andonce a day for eight to 12 weeks in most cases.had rolled out a full screening andIn 2014, VA began a ground-breaking system of care for veterans with the hepatitis C virus (HCV). The Food treatment program that providedandDrugAdministrationapprovedtwonew,highly best practices to healthcareeffectivedrugsSofosbuvir(Sovaldi)andSimeprevir (Olysio)thatworktochangethelivesofveterans systems across the country. infected with Hepatitis C, the VA said in its 2018 budget. VA wants to ensure that all veterans eligible for these 10 THE VALUE OF THE PARTNERSHIP: Industry and the Federal Customer Working Together'