Source: ABC News Author: Lexi Metherell
Hundreds of thousands of Australians with hepatitis C are failing to access new curative drugs, despite the Government subsidising them at huge cost to the taxpayer.
The trend means the Government is at risk of missing its target to eradicate hepatitis C and of spending far more than necessary on the treatments.
Hepatitis Australia said fewer than half as many people were accessing the direct acting antivirals as they were immediately after they were first listed on the Pharmaceutical Benefits Scheme (PBS) in March 2016.
In the first three months after the listing, more than 4,000 people a month were taking them, according to Kirby Institute figures.
But preliminary data suggests that has now dropped to fewer than 1,500 people a month.
"The monthly treatment uptake has tanked," Hepatitis Australia's chief executive Helen Tyrrell said.
She said that threatened the Federal Government's commitment to eliminating hepatitis C in Australia by 2030.
"We need to take action urgently," Ms Tyrell said. "We need to get treatment levels up, well above 20,000 people per annum, and we're falling below that if you're looking at the trajectories at the moment."
The revolutionary drugs, which include ledipasvir and sofosbuvir, were immediately in high demand as people already being treated for hepatitis C rushed to take them.
Prior to being listed, the drugs had cost upwards of $20,000 — they now cost less than $40.
While more than 43,000 Australians have accessed them, it has been estimated there are 200,000 Australians with chronic hepatitis C who have not.
Australia led the world in subsidising the drugs for all people over 18 who needed treatment.
The Federal Government said it would spend over $1 billion over five years paying drug companies for an unlimited supply of the direct acting antivirals.
"There is an absolute economic imperative to treat as many people as possible over the next three years while this five-year supply deal is in place," Ms Tyrell said.
A sleeper virus that can be fatal
Hepatitis C is a virus spread by contact with infected blood. It attacks the liver and serious damage can be done even though patients may show no symptoms.
The disease causes inflammation in the liver and can lead to cirrhosis, end-stage liver disease, liver cancer — and can be fatal.
"It can be quite a silent disease for many, many years," Ms Tyrrell said. "The liver's very accommodating, it tends to compensate very well as the liver disease is worsening."
Ms Tyrell said often people can show no defining symptoms until they have a well-established liver disease. She said the disease affected all walks of life. So, if you're a baby boomer whose drug-taking days are long gone, you could be carrying hepatitis C.
"We need GPs to be thinking about that and not just people who inject drugs, for example," she said.
"It's very, very sad at the moment to hear about people being diagnosed with liver cancer when we've had these medicines available for over a year now, nearly two years."
'I just ignored it, until I was really sick'
Victorian resident Sally (not her real name), 63, said stigma about the blood-borne virus stopped some people from accessing treatment.
"I didn't tell anybody when I first found out that I had it, I was just devastated and I kept it very, very quiet," she said.
"In fact I ignored it really until it started to make me quite sick.
"I know now that my story isn't unfamiliar, that a lot of other people do the same thing."
Sally said the drugs now available on the PBS saved her life and she urged others to get tested.
Royal Australian College of General Practitioners president Dr Bastian Seidel said the early symptoms of hepatitis C — which can include fatigue and nausea — could be vague.
He encouraged GPs to test patients for the disease and said patients should also ask to be tested.
"There's no need [for patients] to go to hospital any more, there's no need to go to see any hospital specialist," he said.
"Your GP can assess you and, in cooperation with a hospital specialist, the medication can be prescribed and treatment can be monitored."
A spokesman for Federal Health Minister Greg Hunt said the Government was committed to eliminating hepatitis C in Australia, which will take a coordinated effort from GPs, specialists, nurses, patients and the Government.
"We would encourage patients who may have hepatitis C to consult their GP or other medical professionals," the spokesman said.
"The Federal Government funds Hepatitis Australia [with] almost $1 million to deliver community education and awareness on hepatitis C, including promoting uptake of hepatitis C treatment."