1.1 Daclatasvir is recommended as an option for treating chronic hepatitis C in adults, as specified in table 1, only if the company provides daclatasvir at the same price or lower than that agreed with the Commercial Medicines Unit.
HCV genotype, liver disease stage |
Treatment |
Duration (weeks) |
Recommendation according to treatment history |
||
Untreated |
Treated |
Interferon‑ineligible or intolerant |
|||
1, without cirrhosis |
Daclatasvir + sofosbuvir |
12 |
Recommended only if the person has significant fibrosis |
Recommended only if the person has significant fibrosis |
Recommended only if the person has significant fibrosis |
4, without cirrhosis |
Daclatasvir + sofosbuvir |
12 |
Not recommended |
Recommended only if the person has significant fibrosis |
Recommended only if the person has significant fibrosis |
1 or 4, with compensated cirrhosis |
Daclatasvir + sofosbuvir (with or without ribavirin) |
24 |
Not recommended |
Not recommended |
Recommended |
3, without cirrhosis |
Daclatasvir + sofosbuvir |
12 |
Not recommended |
Not recommended |
Recommended only if the person has significant fibrosis |
3, with compensated cirrhosis |
Daclatasvir + sofosbuvir + ribavirin |
24 |
Not recommended |
Not recommended |
Recommended |
4 |
Daclatasvir + peginterferon alfa + ribavirin |
24 |
Recommended only if the person has significant fibrosis or compensated cirrhosis |
Recommended only if the person has significant fibrosis or compensated cirrhosis |
Not applicable |
Abbreviation: HCV, hepatitis C virus. Significant fibrosis is defined as METAVIR fibrosis stages F3 and F4. 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 People whose treatment with daclatasvir is not recommended in this NICE guidance, but was started within the NHS before this guidance was published, should be able to continue treatment until they and their NHS clinician consider it appropriate to stop.