Long-term efforts of the international community led to the development of highly efficient direct-acting antivirals (DAAs) that allow treatment of the vast majority of patients with chronic hepatitis C. The proteins encoded in the genome of the hepatitis C virus (HCV) that play a key role in its life cycle (NS3, NS5A, and NS5B) are the targets of this type of drug. There are three classes of DAAs each of which is directed to the inhibition of a specific target protein. Since the HCV has a sufficiently high rate of accumulation of mutations, the development of resistance to these drugs is a big problem. The current recommended treatment regimens with DAAs without the use of interferon and ribavirin are a combination of drugs of different classes providing an increase in the barrier of resistance. Due to the emergence of DAAs, a number of countries (WHO members, with the involvement of Russia) put forward a global strategy to eradicate the HCV. Taking into account the high cost of DAAs and a large number of HCV-infected individuals in Russia, achieving the goals declared by the WHO presents great financial difficulties for our country. However, federal funds allocated for hepatitis C therapy increased significantly over the past 3 years. In addition to increased funding, there is a great potential for reducing the cost of treatment, but its implementation is impossible without the organization of national production of quality generics, issuance of compulsory licenses (given that it is impossible to negotiate with patent holders on licensing), and/or negotiations on price reduction in exchange for volume (for example, the experience of Australia and Portugal). Anyways, Russia faces a very important task to provide therapy for several million patients with hepatitis C in the coming years to get closer to the goal of eradication of the HCV set by the international community.

国际社会的长期努力促成了高效直接作用抗病毒药物 (DAA) 的开发，可用于治疗绝大多数慢性丙型肝炎患者。 丙型肝炎病毒 (HCV) 基因组中编码的蛋白质在其生命周期中起关键作用的（NS3、NS5A 和 NS5B）是此类药物的目标。存在三类 DAA，每类都针对特定靶蛋白的抑制。由于 HCV 具有足够高的突变积累率，因此对这些药物产生耐药性是一个大问题。当前推荐的不使用干扰素和利巴韦林的 DAA 治疗方案是不同类别药物的组合，可增加耐药屏障。由于 DAA 的出现，一些国家（WHO 成员，在俄罗斯的参与下）提出了根除 HCV 的全球战略。考虑到俄罗斯 DAA 的高成本和大量 HCV 感染者，实现世界卫生组织宣布的目标给我国带来了巨大的财政困难。然而，在过去 3 年中，分配给丙型肝炎治疗的联邦资金显着增加。除了增加资金外，降低治疗成本的潜力很大，但如果没有组织国家生产优质仿制药、颁发强制许可（鉴于无法与专利持有人就许可问题进行谈判），其实施是不可能的。 )，和/或以降价换量的谈判（例如，澳大利亚和葡萄牙的经验）。无论如何，