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Hepatitis C will be eradicated from Australia in a decade, doctors say

By Docta, Jul 28, 2016 | | |
  1. Docta
    P1100063.JPG Doctors are predicting the eradication of hepatitis C from Australia by 2026 after a dramatic take-up of new-generation "revolutionary" drugs. Nearly 22,500 patients have commenced treatment since the drugs were listed on the Pharmaceutical Benefits Scheme in March, representing about 10 per cent of all people who are estimated to be living with hepatitis C.

    The new treatment is administered as a course of pills that is consumed for three months and has a 90 per cent cure rate.

    The Kirby Institute's Greg Dore said the drugs were a genuine breakthrough, comparable with the advent of antiretroviral therapy for HIV in the mid-1990s.

    "This is a revolution in clinical medicine that we haven't seen for decades, where you go from a really problematic complex therapy to a really simple, well-tolerated, highly curative therapy," Professor Dore said.

    "It's truly transformative clinical medicine being applied at a population level."

    The new-generation drugs, which include Harvoni, Sovaldi and Daklinza, were listed by the Therapeutic Goods Administration last year but were prohibitively expensive at $66,000 a course.

    Some patients joined a Dallas Buyers Club-style scheme to import generics from China and India, but these were still beyond the reach of many patients at $1500-$1900 for the 12-week course.

    But patients can now access them for $7 to $14 a month if they have a healthcare card, or $36 to $72 for everyone else.

    Under the $1 billion deal negotiated by the federal government, the manufacturers will continue to supply Australia with the drugs free after a cap of about 13,000 patients a year have been treated.

    Data from the Kirby Institute shows 22,470 patients in Australia have already accessed the treatment since March.

    Professor Dore projected the take-up rate had exceeded all expectations and would result in more people being treated in 10 months than would have been treated in 20 years of the old therapies, if the rate continued to the end of the year.

    "Everyone's a winner in this scenario," Professor Dore said. "The companies still make a lot of money. The government has got a good deal. Patients win."

    Australia was on track to treat 80 per cent of patients and reduce new cases 90 per cent by the end of the decade, virtually eliminating the disease, he said.

    The take-up has been highest in Victoria, where 13 per cent of the state's 55,760 people with hepatitis C have begun treatment, and lowest in South Australia and Western Australia where only 5 per cent of the hepatitis C population have bought the drugs.

    NSW has the largest hepatitis C population of 81,940 and 9 per cent of people have started the treatment.

    Centre for Population Health executive director Jo Mitchell said NSW Health was encouraging people to start the treatment, now that it was affordable, to reduce transmission rates in the community.

    Although the uptake had been higher than expected, she expected it to drop off after the people who were most aware and ready for the new treatments had received it.

    "But NSW Health is taking a very particular approach in making sure that the most marginalised people get access to treatment," Dr Mitchell said.

    This included making it available in drug and alcohol services.

    Hepatitis C is a blood-borne disease that affects the liver and is often spread by sharing needles. It can cause cirrhosis, end-stage liver disease, liver cancer and death.

    East Sydney GP David Banker has 2000 patients with hepatitis C on his database, with symptoms ranging from none to advanced liver disease, but he was careful about prescribing the previous interferon-based treatment because it was so toxic.

    The drug was administered by injection during 48 weeks, with potential side effects including severe depression and psychosis, and the cure rate was just 75 per cent.

    "Most people are surprised when I say hepatitis C is pretty much totally curable now," Dr Baker said. "It's had a huge impact."

    Sara, who contracted hepatitis C by sharing drug equipment about two years ago, did not need persuading to get a prescription for the new drugs the minute they were listed.

    Although she had tested positive to the disease, she had not had symptoms – which are often not apparent for decades after infection – so the disadvantages of the old treatment outweighed the benefits.

    "There's stigma and discrimination throughout society when it comes to this virus and you feel embarrassed if you end up becoming infected with it," said Sara, who asked that her surname not to be used.

    "So you keep it to yourself until you feel you have to explain it to people. Because it's chronic, you're not scared initially, but you want to do something about it because it can affect your quality of life."

    After taking a single pill, morning and night, for three months, she was cured.


    Harriet Alexander- July 28 2016
    Fairfax Media Copyright © 2016

    Image credit: drugs-forum
    http://www.smh.com.au/national/heal...-in-a-decade-doctors-say-20160727-gqeurm.html

Comments

  1. Alfa
    I hope that the UK NHS, the US and the EMCDDA take notice of this and implement similar schemes to quickly end all Hepatitis C.
  2. aemetha
    NZ could wipe out hepatitis C nationwide

    A world expert on hepatitis C says the disease could be eliminated from New Zealand within the next 20 years.

    Hepatitis C is an infectious blood-borne virus that attacks the liver, leading to liver failure and liver cancer. New funding for drugs will see at least 2000 Kiwis cured each year, but that's just half the battle. In New Zealand, around 50,000 people have chronic hepatitis C, but only 40 to 50 percent are aware they have it.

    From July 1 Kiwis now have access to two new breakthrough medicines. The new wonder drugs come in tablet form and have a 95 percent success rate. And for patients, it's life-changing. Wendy Overy was infected with hepatitis C following a blood transfusion in the 80s, before screening was introduced. She says it always made her feel "diseased". "It's like this alien thing inside you," she says. Ms Overy was offered a clinical trial of the new drug Harvoni three years ago, and after 12 weeks the virus was gone.
    "I was cured, and it was like wow, a whole new chapter of life now," she says.

    Paul Adriannse was treated with Viekira Pak at the end of 2015 and was cured. "About 10 tablets a day I had to take, minimal side effects, it was great," he says. "So three months, blood test at the end of it, no virus detectable. I cried. I just burst out. She said, 'Look, you're cured', and I just broke down."

    "This is the first infectious disease ever, where you've gone from discovery to cure within a quarter of a century," says liver specialist Prof Ed Gane. But 50 percent of people don't know they have it, and the drugs will only treat one of the types of hepatitis C.

    Pharmac chief executive Steffan Crausaz says it's a start. "We're expecting to cure at least 20,000 patients with hepatitis C with the treatments we've already announced, now we also need to look to the future," he says. To wipe out the disease altogether, Pharmac will need to fund more treatments. "Those treatments have recently been approved by the FDA and we think they will be approved here in New Zealand in the next few months," Mr Crausaz says. "We're hoping that Pharmac will expand the access in the next year or so to include people with all genotypes."

    Now there's a cure, it's hoped it will encourage more people to get tested and diagnosed for treatment.

    Newshub
    http://www.newshub.co.nz/nznews/nz-could-wipe-out-hepatitis-c-nationwide-2016072819#ixzz4FkgHGSDv
  3. aemetha
    It's very pleasing to see this being picked up in New Zealand. Pharmac is usually quite slow to respond to newer treatments preferring to see extended periods of efficacy overseas before they commit to new medications.
  4. Docta
    I'm left wondering why Australia and soon possibly New Zealand will be the only country's to make a Hep-C eradication deal with these drug manufacturers. Its certainly not for economic reasons because the cost to the taxpayer for funding a cure program is absolutely miniscule in comparison to a lifetime of medical support for a Hep-C patient. Important to note that Hep-B is also being eradicated via vaccine.

    Leads me to think maybe its the stigma associated Hep-C as an IV drug addicts disease making it politically unpalatable or possibly Pharma lobbying by the manufacturers of the older drug therapy's that treat Hep-C instead of curing it. I try not to take much notice of all this talk of cures being covered up or conspiracies by Big Pharma but when absolute irrefutable evidence of a cure is put in front of every public heath official in the world and all but one or two take no action it makes you think.
  5. TheBigBadWolf
    I don't think Hep C will be eradicated soon.
    Therapy is too expensive for What we call "the third world". And Big Pharma will not spend what money they made from rich countries to heal the poor.

    Because there is where people know nothing about world's biggest killer. As long as Hep C stays a Non- topic in Western Countries nothing at all will change.

    BBW
  6. aemetha
    GPs can now prescribe new Hep C drug

    [IMGR="white"]https://drugs-forum.com/forum/attachment.php?attachmentid=52589&stc=1&d=1475327808[/IMGR]The availability of a new drug is a huge step towards eliminating hepatitis C in New Zealand, the Hepatitis Foundation says.

    From today, the drug Viekira Pak will be fully funded by Pharmac.

    Viekira Pak had been listed since 1 July, but with a restriction limiting access to funded treatment to infectious disease specialists, gastroenterologists and hepatologists.

    This restriction has been lifted from today, meaning that any relevant prescriber will be able to access full funding for the drugs.

    Hepatitis specialist Ed Gane said the treatment used previously, which involved weekly injections, had such bad side-effects that almost 20 percent of patients stopped using it.

    But he said Viekira Pak had much better outcomes.

    "It is a very safe and effective treatment. It's only 12 weeks duration and tablets - no need for injection, very well tolerated and has cure rates of between 95 and 100 percent."

    The foundation believes the new drug will be a game changer in treating the disease, as it has a success rate of more than 95 percent.

    The foundation estimates 50,000 New Zealanders are infected with hepatitis C.

    Dr Gane said the ability of GPs to treat patients with Viekira Pak is a significant first step towards eradicating Hepatitis C from the country by 2030.

    1 October 2016
    Radio New Zealand
    Photo: 123rf
    http://www.radionz.co.nz/news/national/314664/gps-can-now-prescribe-new-hep-c-drug
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