New hepatitis C treatment data confirms time for action is now

Statement

The latest hepatitis C treatment data released by the Kirby Institute shows that, since March 2016, an estimated 70,260 people in Australia have commenced treatment to cure hepatitis C*.  Based on the estimated number of people living with chronic hepatitis C infection at the end of 2015 this represents about 33% who have started treatment.  But is this enough to prevent the ongoing deaths each year in Australia from liver disease associated with hepatitis?

The data in Monitoring hepatitis C treatment uptake in Australia – Issue 10 from the Kirby Institute highlights both the progress and deficiencies in hepatitis C treatment uptake. It is great news to see so many people have commenced treatment with most people having been cured, or on their way to being cured. While this is clearly cause for celebration the down side is that the number of people taking up treatment to cure hepatitis C is declining to alarming levels.

We know from other sources that the overall downward trend in the number of people commencing treatment has continued beyond the end of 2018, averaging at or below 1000 people per month in 2019, well short of the government’s targets.  To address this ongoing decline there needs to be a significant push in primary care to identify patients who may need treatment for hepatitis C and help them achieve a cure.

Despite general practitioners (GPs) being able to prescribe the current treatments, this report shows only 29% of prescriptions are issued by GPs*. We estimate this equates to only 10% of all GPs prescribing hepatitis C treatment. We need 90% of GPs in Australia having written a script for these treatments.

The Kirby Institute report also shows that while there has been a significant increase in people under 50 accessing the curative medicines this is not the case for older people. We know from our analysis in 2017 that a large proportion of people living with hepatitis C are now aged over 50 and are not engaged in care for their hep C. Many in this older group may not be aware of the hep C cure being available or may simply be putting some health issues down to getting older.

Hepatitis Australia is currently working with our member organisations to roll out a community education campaign targeting the older age group living with hepatitis C. The Test Cure Live campaign was recently run in Canberra and Adelaide but community education is only one strategy, and can only achieve so much without support and education by the health sector. We need primary care services to be coming to the party and talking to patients about hepatitis. They need to be assessing hepatitis risks that may have occurred in the past, testing for hepatitis C and working with the patient to achieve a cure. We have consistently raised this shortfall in approach for almost two years – the time for action is now. 

The Australian Government has set hepatitis B and hepatitis C eliminations targets for 2022, which are outlined in the National Hepatitis Strategies. Australia has also signed on to the global elimination targets for 2030.  Hepatitis Australia is concerned the hepatitis C treatment targets will not be achieved unless action is taken to increase prescribing in primary care settings.

Hepatitis Australia hopes the overall downward trend in hepatitis C treatment initiations in 2018 from this recent report will prompt action. It reinforces the current trends in 2019 which show monthly treatment initiations are now consistently well below the required figure previously indicated by the Chief Medical Officer. 

The Health Minister committed to convening a roundtable on why Australia has failed to stem the tide of avoidable deaths from hepatitis. It is time for the sector to come together and help solve this problem. If action is not taken quickly to turn these figures around, Australia risks missing the global targets it has publicly committed to. More importantly, people will be missing out on a cure for their hep C and unnecessarily be developing and at risk of death from  serious liver disease.

Kevin Marriott
Acting CEO
Hepatitis Australia

 

Kirby Institute, Monitoring hepatitis C treatment uptake in Australia, Issue #10 June 2019, University of NSW, Sydney Australia