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Treatment and care

In Australia, effective, subsidised treatment is available for hepatitis B and most people can be cured of hepatitis C with a pill taken daily for eight to twelve weeks. But treatment can only be effective if accessible to those who can benefit from it. Around three-quarters of people with hepatitis B in Australia are not receiving essential six-monthly monitoring and less than half of those eligible for treatment are receiving it.[3]

Hepatitis Australia’s contribution

  • Support members, e.g. training in working cross-culturally
  • Advocate for change, e.g. removing restrictions on prescribing and universal access to treatment and care
  • Develop tools for members, e.g. local data reports for engagement with Primary Health Networks (PHNs)
  • Identify funding and promote the adaptation of proven initiatives, e.g. Hep B PAST and HepLink

 

Implementation plan

Priority How we will achieve it When we will do it
Education
  • Support members to promote community awareness of the importance of regular monitoring to prevent and detect progression to cirrhosis or liver cancer due to hepatitis B (including coinfection with hepatitis D) and hepatitis C.
 
  • Explore options with members and clinical partners to ensure people diagnosed with hepatitis D are engaged in care given more rapid progression to liver disease.
 
  • Develop with members approaches to support people who discontinued hepatitis C treatment and require testing to establish their status and support to re-engage in and complete treatment.
 
  • Work with members to identify and publicise the details of medical and nurse practitioners who are experienced in hepatitis B and hepatitis C treatment and who are recognised for their provision of quality care.
 
  • Provide workforce training and support and establish consensus on minimum standards for the translation of education materials and the use of health translation services and multilingual hepatitis B workers
 
  • Explore with members the potential of artificial intelligence and other emerging technology in overcoming language barriers and promote the adoption of safe and acceptable options.
More care, closer
to home
  • Recognising the need for all people with hepatitis B to be engaged in care, advocate for the dual s100/s85 listing of hepatitis B medications so all medical and nurse practitioners can prescribe treatment.
 
  • Use the transition to dual listing to work with ASHM to promote hepatitis B management by medical and nurse practitioners.
 
  • Advocate for the Medicare rebate for hepatitis B viral load testing to be available in accordance with clinical need (and not limited, as it is at present, to one test each year).
 
  • Explore with members, clinical partners and people with hepatitis B options to make life-long monitoring more accessible.
 
  • Advocate for hepatitis D treatment to be considered for subsidy by the Pharmaceutical Benefits Advisory Committee at the earliest possible time.
 
  • Advocate for the removal of PBS requirements that prevent medical and nurse practitioners from prescribing hepatitis C treatment unless they are experienced or have consulted a specialist.
 
  • Advocate for medical specialists to triage any person referred by their GP for hepatitis C treatment or care without additional clinical complexity to a suitable and available GP so that treatment initiation and care is not delayed due to waiting times for specialist services.
Universal access
  • Explore with members and through BBVSS the state and territory arrangements for the treatment and care of people with hepatitis B who are not eligible for Medicare and promote options to strengthen access
 
  • Continue to work with the Department of Home Affairs and migration health providers to ensure new migrants with hepatitis B are supported with connected to care.
 
  • Explore with epidemiologists, social researchers and people with hepatitis B (including those with hepatitis D coinfection) options to better characterise migration experience and cultural, linguistic and other diversity among people with hepatitis B, including through qualitative research.
Support primary
care
  • Explore through BBVSS and with the Department of Health and Aged Care options to improve hepatitis B and hepatitis C care and treatment in PHNs with below average scores on these measures.
 
  •  Develop guidance for members and stakeholders on best practice engagement and influencing with PHNs, based on success in hepatitis B and hepatitis C and broader health areas.
 
  • Work with members, PHNs, clinicians and researchers to better understand and address the wide variation in hepatitis B care and hepatitis C treatment across PHNs and at state and territory level.
 
  • Annually compile local and comparative hepatitis B and hepatitis C prevalence, diagnosis, treatment and morbidity data in accessible ways at PHN-level and work with members to engage PHNs on areas of strength and for improvement.
 
  • Work with research partners to consolidate data and find new ways, including through data linkage to indicators of socio-economic status, to understand the impact of out-ofpocket costs on hepatitis B treatment and care.

 
Implementation
  • Consider how learnings from the Hep B PAST project in the Northern Territory could be applied in other locations and work with partners to identify avenues to finance this translation.
 
  • Work with members and researchers to design, implement and evaluate peer models that use lived experience to improve connection to harm reduction, testing, treatment initiation and care, including through HepLink
 
  • Partner with researchers and people with hepatitis C to understand the extent of and contexts for people’s choices not to initiate treatment, including in prisons and other places of held detention.