St Vincent's Director of Gastroenterology Professor Alex Thompson
St Vincent's Director of Gastroenterology Professor Alex Thompson and Burnet Institute’s Professor Margaret Hellard respond to media reporting of Australia’s hepatitis C treatment program.
Recent inaccurate reporting in the Australian media about the true cost to taxpayers of Australia’s landmark hepatitis C treatment program has created further stigma towards hepatitis C patients.
Australia is currently a world leader in the progress towards eliminating hepatitis C as a public health threat. Hepatitis C is a blood-borne, chronic infectious disease that affects more than 220,000 Australians and causes an estimated 770 deaths each year. In 2013, 44,000 Australians were living with severe liver fibrosis or cirrhosis, 1400 people developed liver failure, and 530 were diagnosed with liver cancer due to hepatitis C.
The broad availability of new highly effective treatments known as direct-acting antivirals (DAAs) in Australia means we are well placed to stop people dying from the complications of hepatitis C and to stop the ongoing transmission of the hepatitis C virus.
The Federal Government has announced it is providing over AUD$1 billion dollars over five years through the Pharmaceutical Benefits Scheme (PBS) to treat hepatitis C. Whilst the full details of the funding deal are not known for privacy reasons, it is understood that clever negotiations by government established a risk-sharing program that means treatment costs are capped at no more $300 million annually over the five year period, regardless of the number of people undergoing treatment. Therefore, the higher the treatment numbers are, the lower the cost per course of treatment in that year.
In fact, with the current number of prescriptions already written in 2016 it is projected that around 30,000 Australians will cured of their hepatitis C for a very low cost per treatment course in the first year of the scheme. The price of DAA treatment in Australia is one of the lowest prices in the developed countries, with our broad access program the envy of the world. Once cured, people have a much lower risk of liver cancer and liver failure, and can no longer transmit infection. This open access policy, with broad uptake, is vital to interrupt transmission of hepatitis C, and eventually to eliminate hepatitis C as a public health issue.
Further stigma is created when people question who should receive these life-changing therapies. It is vital that an evidence-based, not stigmatising, approach is taken to all health care in Australia. To suggest that some Australians are not worthy of having life-saving curative treatment for hepatitis C based on their current or past behaviours is extraordinary. It only further marginalises and stigmatises people who inject drugs and prisoners – two key groups at high risk of hepatitis C. If we want to stop the hepatitis C epidemic in Australia it is vital we engage with, not ignore, key vulnerable populations in our community.
Authors:
Professor Alex Thompson
Director of Gastroenterology St. Vincent’s Hospital Melbourne
Professorial Fellow and NHMRC Research Fellow, University of Melbourne
Gastroenterology Society of Australian/Australian Liver Association
Professor Margaret Hellard
Head, Centre for Population Health, Burnet Institute
NHMRC Senior Principal Research Fellow
Head, Hepatitis Services, Department of Infectious Diseases, The Alfred Hospital Adjunct Professor, Infectious Diseases and Epidemiology, Monash University