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
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