1 Recommendations

1.1 Sofosbuvir–velpatasvir is recommended as an option for treating chronic hepatitis C in adults, as specified in table 1, only if the company provides the drug with the discount agreed in the simple discount agreement.

Table 1 Sofosbuvir–velpatasvir for treating chronic hepatitis C in adults

HCV genotype

Liver disease stage

Treatment

Recommendation according to treatment history

Untreated

Treated

1

With or without compensated cirrhosis

Sofosbuvir–velpatasvir

Recommended

2

Without cirrhosis

Sofosbuvir–velpatasvir

Recommended only for people who cannot tolerate interferon or it is not suitable for them

Recommended

Compensated cirrhosis

Sofosbuvir–velpatasvir

Recommended

3

Without cirrhosis

Sofosbuvir–velpatasvir

Recommended

Compensated cirrhosis

Sofosbuvir–velpatasvir (with or without ribavirin)

Recommended

4

With or without compensated cirrhosis

Sofosbuvir–velpatasvir

Recommended

5

With or without compensated cirrhosis

Sofosbuvir–velpatasvir

Recommended

6

With or without compensated cirrhosis

Sofosbuvir–velpatasvir

Recommended

1–6

Decompensated cirrhosis

Sofosbuvir–velpatasvir (with ribavirin)

Recommended

Abbreviation: HCV, hepatitis C virus.

Treated – the person's hepatitis C has not adequately responded to interferon-based treatment.

1.2 It is recommended that the decision to treat and prescribing decisions are made by multidisciplinary teams in the operational delivery networks put in place by NHS England, to prioritise treatment for people with the highest unmet clinical need.

1.3 This guidance is not intended to affect the position of patients whose treatment with sofosbuvir–velpatasvir was started within the NHS before this guidance was published. Treatment of those patients may continue without change to whatever funding arrangements were in place for them before this guidance was published until they and their NHS clinician consider it appropriate to stop.