Hepatitis Australia: Urgent action required as 'elimination' goal slips further

Source: PharmaDispatch. Author: Paul Cross

Hepatitis Australia has expressed disappointment over the lack of response in this year's Budget to the dramatic decline in the uptake of the direct-acting antivirals for hepatitis C.

The utilisation of the therapies first reimbursed in Australia in March 2016 has slumped with Hepatitis Australia saying the goal of elimination by 2030 is now not achievable without action.

The organisation welcomed the government's Budget commitment to the national strategies addressing blood-borne virus (BBVs), particularly the increased focus on Aboriginal and Torres Strait Islander health.

Yet it also noted the lack of additional support to reverse what it describes as the "sharp decline" in people being cured of hepatitis C and the apparent lack of recognition of liver cancer and deaths related to hepatitis B.

According to Hepatitis Australia CEO, Helen Tyrrell, “Combined there were almost 2,000 deaths in Australia caused by hepatitis B and hepatitis C in 2016 and 2017. The treatment that could have averted a large proportion of these deaths simply did not reach people in time. Experts are now saying the nationally agreed global mortality reduction targets probably won’t be reached by 2030.”

Hepatitis B and hepatitis C are the leading causes of liver cancer in Australia. Liver cancer is one of the 10 most commonly diagnosed cancers in men and has one of the lowest five-year survival rates, resulting in it being one of the 10 most common causes of death from cancer for both men and women in Australia.

“Liver cancers from chronic hepatitis B and C are preventable. Action must be taken to support the 416,091 people currently living with hepatitis B and hepatitis C to facilitate awareness and engagement in care before serious liver disease develops” said Ms Tyrrell.

The Budget included $485 million in changes to Medicare's Chronic Disease Plan. Hepatitis Australia said the government should include the diagnosis and treatment of hepatitis B and hepatitis C as key health priorities under these plans. It recommended the annual allocation of $10 million over the next three years for the identification and treatment of hepatitis B and C in primary care.

The current levels of engagement among GPs to treat hepatitis B and cure hepatitis C are grossly inadequate, it said, highlighting the fact that only 10 per cent are prescribing the curative treatments for hepatitis C. Around 90 per cent of GPs have 2-10 patients in their practice that could be diagnosed and cured of hepatitis C.

“While we are grateful for the $1million provided to Hepatitis Australia last year to boost community awareness of the hepatitis C cures, we reiterate that the funding allocation for this work needs to be commensurate with the scale of the problem if we are going to reduce liver cancer and avoidable deaths. We therefore request $10m targeted towards community awareness and engagement in care to support the implementation plans for the National Hepatitis B and National Hepatitis C Strategies over the next three years,” said Ms Tyrrell.

“Appropriate treatment relies on timely diagnosis. Diagnosis requires access to testing.” 

She continued, “Australia has committed to the WHO targets of elimination of hepatitis B and hepatitis C by 2030.  Without adequate support in the primary care setting and community education, these targets are not achievable. For 18 months now government has watched treatment rates for HCV decline. The time to act is now before Australia takes too many steps back along the road to success.”

Note: This article has be republished with the permission of PharmaDispatch.