After a decade as rivals, drugmakers Merck & Co. and Roche are teaming up to market their hepatitis C medicines just as drugs from a new class are about to transform treatment of the tough-to-cure virus.

Merck's Victrelis, approved last Friday, and Incivek from Vertex Pharmaceuticals, expected to be approved soon, are the first new treatments for hepatitis C in about 20 years. They significantly boost cure rates when used in combination with the current mainstay drugs, which cause flu-like side effects for months and still don't cure most patients.

Merck, looking to maximize the benefit of being first to market, said Tuesday it's reached a deal under which Roche Holding AG sales representatives will promote Merck's Victrelis pills as part of a new triple combination therapy, with Roche's injected hepatitis C drug Pegasys and ribavirin pills.

"We're maximizing the potential of our new drug" with this deal, Merck spokesman Ian McConnell said in an interview.

Merck salespeople will promote Victrelis along with its similar injected drug, PEG-Intron, and ribavirin. Ribavirin is available as a cheap generic as well as Merck's brand-name drug, Rebetol, and Roche's brand, Copegus.

"Triple combination therapy for hepatitis C marks a major change in the way this disease is treated," Pascal Soriot, chief operating officer of Roche's pharmaceuticals division, said in a statement.

The Roche sales force will start promoting the three-drug combination, likely to cost tens of thousands of dollars for months of treatment, to U.S. physicians, then expand to other countries. The two companies also will educate patients about hepatitis C diagnosis and treatment options.

"This is a win for Roche to safeguard Pegasys' market share," Citigroup Global Markets Inc. analyst John Boris wrote to investors. It's "also a win for Merck to boost promotion of Victrelis."

Merck and Roche, both Top 10 drugmakers by revenue, have huge sales forces compared to tiny Vertex. The Cambridge, Mass.-based company had only $143 million in revenue last year and lost several times that much, but has a strong partner that will market Incivek outside the U.S. _ Johnson & Johnson.

Meanwhile, researchers at Merck, which is based in Whitehouse Station, N.J., and Switzerland's Roche will collaborate on testing new combinations of existing and experimental hepatitis C medicines from their companies.

The partnership comes after Roche and Merck's Schering-Plough unit spent more than a decade battling for supremacy in the market for hepatitis C drugs. Roche and Schering each produced ribavirin pills and long-acting, genetically engineered versions of the immune system protein interferon: Roche's Pegasys and Schering-Plough's PEG-Intron.

Those injected drugs, together with ribavirin, boost the immune system to fight the hepatitis C virus.

Victrelis and Incivek are part of a new drug class called hepatitis C virus protease inhibitors that block an enzyme needed for the virus to copy itself.

Studies showed the Victrelis three-drug regimen boosted the cure rate to about 66 percent after 48 weeks, from about 40 percent with just ribavirin and interferon.

Hepatitis C can linger silently in the body for years or even decades. By the time it's discovered, liver damage is often so severe a transplant is the only option, and livers are always in short supply.

The new combination treatment carries the same serious side effects as the interferon-ribavirin combination, including nausea, anemia, fatigue and a persistent unpleasant taste in the mouth. With the addition of Victrelis, more patients experienced anemia and unpleasant taste. Because ribavirin can damage or kill a fetus, the new combination cannot be taken by pregnant women or their male partners.


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