Hepatitis Australia: Need for action as the task 'just got more difficult'

Source: PharmaDispatch. Author: Paul Cross

Hepatitis Australia has expressed understanding, disappointment and concern over MSD's decision to cease all promotion of its direct-acting antiviral for hepatitis C, ZEPATIER (grazoprevir and elbasvir).

The company communicated the decision to stakeholders, confirming in a follow-up response to PharmaDispatch that its decision was in response to the dramatic decline in the uptake of the direct-acting antivirals and "reimbursement pricing caps based on unreasonable patient numbers" and unsustainable rebates.

Hepatitis Australia has been outspoken and consistent in its call for action over the dramatic decline in the uptake of the cures for hepatitis C first listed on the PBS in March 2016.

“Hepatitis Australia appreciates the commercial decisions that MSD must take with respect to their business and we are grateful they will continue to make their product available in Australia. It has transformed the lives of many patients to date and will continue to be an important treatment option for clinicians to discuss with their patients," said the organisation association in a statement.

"However, the loss of the marketing and education from MSD is of significant concern to us. As the major primary care provider in the three companies supplying HCV treatment in Australia, the job of Hepatitis Australia in educating the community and ensuring education and support for prescribing in primary care just got more difficult."

The organisation used its 2019-20 pre-Budget submission to repeat its call for government intervention to address the decline in uptake through initiatives including programs focused on primary care.

"We have called on the government for 18 months now to address the issue of GP prescribing rates in Australia, to encourage the 90% of GPs not prescribing HCV treatments to review their patients, diagnose, treat and cure HCV and reduce the unacceptable rate of liver cancer deaths associated with this disease," it said in statement issued late yesterday.

"With monthly initiation rates sitting well below the Chief Medical Officer’s advice on those necessary to eliminate this disease in Australia, we are asking all political parties to commit to making curing Hepatitis C a priority for everyone in our community particularly those who do not know that this treatment exists.

"We need education of the community and clinicians and we need it in unison. Australia’s vaccination programs show the value of this combined messaging and education for changing health outcomes.  This education needs to be supported with time limited access to incentive payments or chronic disease plan items on the MBS to support patients as well as those who provide their care. Diagnosing and curing hepatitis C should be a KPI for every general practice in Australia.

"Australia has made the cure available – now let’s teach those that can save lives how to use it,” it added.

Note: This article has been republished with the permission of PharmaDispatch

Hepatitis Australia Seeks Federal Election Commitments for Hepatitis B and Hepatitis C

We are at a critical juncture - without immediate increased investment and action the 2022 National Hepatitis B and Hepatitis C targets will likely not be achieved and promise of elimination may fade away. In the lead up to the 2019 Federal Election Hepatitis Australia has laid out our requests to the major parties to get us back on track

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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.

Government happy with status quo for hepatitis as WHO elimination targets start to slip and cancer rates increase

Hepatitis Australia welcomes the Government’s broad commitment to Australia’s National Strategies addressing blood borne virus (BBVs) and in particular supports its increased focus on Aboriginal and Torres Strait Islander health and the broader Indigenous health funding announced in the Federal Budget. 

However, Hepatitis Australia notes the lack of additional support to reverse 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.

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New option for those missing out on a cure for hep C

From 1 April an additional medicine to cure hepatitis C has been listed on the Pharmaceutical Benefits Scheme (PBS) adding to the current list of direct-acting antivirals (DAAs), which started being listed back in March 2016.

As outlined on the PBS General Statement for Drugs for the Treatment of Hepatitis C, VOSEVI® (sofosbuvir with velpatasvir and voxilaprevir) has been listed as a re-treatment option for people who have not had success with other DAAs containing a NS5A inhibitor.  

The medicines listed since March 2016, used to treat hepatitis C, are all highly effective offering a cure for most people who take them. However, for just over 3% of people who have used the existing DAAs, a cure has not been forthcoming.  It is hoped the introduction of VOSEVI® may change this after 12 weeks of treatment.

People who have tried the existing DAAs but have not been cured are encouraged to go back to their doctor to discuss trying this new treatment option. 

It is hoped that having this new DAA will now elevate the success rates of the new medicines and see 100% of people with hepatitis C being cured of the virus.

At Hepatitis Australia we will shortly be updating our information about hepatitis C treatment to include VOSEVI®