New hep C meds now need awareness

Now that new generation medicines for hepatitis C have been subsidised on the PBS, the Government needs to invest in raising awareness about them and the disease, stakeholders say.

In announcing the PBS subsidy of the medicines, Health Minister Sussan Ley said that when taken as prescribed, the four breakthrough medicines listed today have a cure rate of over 90% and work faster and with fewer side effects than anything else previously subsidised on the PBS.

“Australia is one of the first countries in the world to publicly subsidise these cures for every one of our quarter-of-a-million Hep C suffers, no matter what their condition or how they contracted it,” Ms Ley says.

“We are hoping to eliminate one the great disease challenges facing Australia in the 21st century.”

But many Australians living with hepatitis C are still completely unaware of the new treatments or the benefits they offer, says Hepatitis Australia.

“People aged over 40 may not have symptoms of liver disease, but if they are not engaged in hepatitis C care they remain at high risk of silently progressing to cirrhosis, liver cancer and liver failure,” Hepatitis Australia CEO Helen Tyrrell says.

“It is vital that the message goes out loud and clear that there has never been a better time to treat and cure hepatitis C.”

She urged all people who know they are living with hepatitis C to seek a liver check-up and discuss their treatment options with their doctor.

Tyrrell told the AJP that the wider health professional community will need to be aware of the new options for treatment, and will play an important role in providing care.

Because it will not be possible to treat 230,000 Australians in liver clinics, there will need to be prescribing by GPs and dispensing by community pharmacists, she says.

Tyrrell told the AJP that community pharmacy is ideally placed to provide medicines near to where people live, and that pharmacists need to be supported to be able to dispense hepatitis C medicines.

A consensus document which has been prepared by Gastroenterological Society of Australia Australian Liver Association (GESA ALA) and Hepatitis Australia, among other stakeholders, explains that the new treatments will be able to be prescribed by gastroenterologists, hepatologists or infectious diseases physicians who are experienced in treating chronic HCV infection, as well as GPs who are eligible to prescribe under the PBS in consultation with one of these specialists.

“PBS authority approval from the Department of Human Services (Medicare) — via written or telephone chan­nels — will be required for each prescription; the medicines will not be available under streamlined authority,” it says.

The new HCV medicines will be available through the PBS General Schedule (Section 85), as well as the Section 100 Highly Specialised Drugs (HSD) Program.

“This means that it will be possible for approved pharma­cists in the community to dispense the new HCV medications. The S100 listing makes provision for treatment of prisoners through the HSD Program.

“The S85 provision for community dispensing of DAA therapy by GPs is intended to increase capacity to allow upscaling of treatment rates to the desired level for reducing population burdens of HCV and secondary liver disease. The development of new models of care for HCV treatment will be necessary.”

GESA ALA chair Associate Professor Amany Zekry says that people who are concerned they may have been exposed to the virus at any stage in their life are encouraged to get tested.

“It is vital that healthcare professionals – including general practitioners – are proactive and offer people living with the hepatitis C virus a liver check-up to assess liver damage and discuss treatment options,” says A/Prof Zekry.

Currently only one per cent of Australians living with hepatitis C is treated each year, leaving many more people at risk of developing serious liver disease including liver cancer, liver cirrhosis and liver failure.

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  1. Sam Holt

    Here is a great video by leading HepC advocate Dr. James Freeman that outlines everything you need to know if you are interested in the HepC medication =

  2. Drugby

    Great video, Sam. One important aspect not mentioned is the potential for drug-drug interactions, including with complementary medicines like St John’s wort. Acid reducers like antacids, PPIs and H2-blockers also interact with Harvoni, leading to reduced absorption. Some statins are contraindicated with the new DAAs. Pharmacists can play a really important role here, as the outcome of many of the interactions is hep C treatment failure. These are expensive drugs, so need to be used optimally.

  3. Drugby

    One in every 100 Australians has hep C, with another 10,000 people diagnosed every year, so it is critical community pharmacists have a good understanding of these new drugs and can dispel any myths. They have high cure rates, are well tolerated (compared with terrible adverse effects from previous treatments peg-IFN and RBV) and are taken for short duration – usually 12 weeks.

    THE Health Department has published a new Hepatitis C Medicines Fact Sheet for community pharmacies, detailing the arrangements for the newly listed PBS medications which became available yesterday.

  4. Better call me Saul

    Remember when Celebrex came on the PBS? Yikes! The PBS medicines bill went through the roof and extrapolating linearly showed that ‘we’ll all be rooned.’ Except future projections always flatten out.
    For these $$$$ treatments for drop-kicks who self-inflicted themselves with Hep-C and aren’t even taxpayers themselves — watch out! I predict a 20% GST to cover the gazillions that will be spent.

    • Justine Parer

      Its a public health measure. What’s good for ‘them’ is ultimately good for everybody.

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