Monash-led research team implores government to subsidise hepatitis C drugs

Professor Sievert

In a letter to the Medical Journal of Australia published today, a leading Monash researcher is asking for hepatitis C virus patients to gain improved access to drugs to avert liver related deaths.

Hepatitis C virus (HCV) infection is a major public health burden in Australia, with estimates of 230,000 people chronically infected.

HCV is a significant cause of advanced liver diseases including progressive liver fibrosis, cirrhosis and hepatocellular carcinoma (liver cancer).

Fortunately, there is a revolution in HCV treatment with the advent of new drugs, known as direct acting antiviral (DAA) therapy.

“During this decade, simple (oral tablets rather than injections), tolerable, short duration (6-12 weeks) therapy with extremely high efficacy (cure rates above 90%) should become the norm for the  HCV-infected population,” said lead author and Director, Gastroenterology and Hepatology Unit at Monash Health and Monash University Professor of Medicine William Sievert.

“However, the high cost of DAA regimens and competing public health priorities may limit the potential impact of new HCV therapies.”

Currently, the cost of DAA treatment is out of reach for most HCV patients.

“The large number of liver-related deaths every year caused by HCV places an enormous burden on our health system,” said Professor Sievert.

“Our research team modelled how the HCV disease burden and associated health care costs in Australia will increase as the infected population ages.”

“We demonstrated that increasing the efficacy of antiviral therapy and the number of patients treated could avert the expected increase in HCV liver related deaths and end stage liver disease.”

Importantly, compared to previous regimens, DAA therapies offer higher cure rates, simplified dosing, shorter treatment duration and are better tolerated, albeit at a substantial price.

Professor Sievert’s team examined the impact of delayed access to DAA treatment by modelling one and two year delays.

“We estimate that if the current treatment regimens continue in Australia, there will be approximately 22,200 liver related deaths between 2014 and 2030,” said Professor Sievert.

“However, if DAA treatment is made widely available and accessible through the Pharmaceutical Benefits Scheme (PBS), that number of deaths will decrease to 13,500 in the same time period.”

Alarmingly, for every year of DAA treatment delay, thousands of HCV infected patients will die or develop advanced liver disease.

“If we delay just one year, there will be an extra 900 liver related deaths, 800 new cases of cirrhosis and 500 new cases of liver cancer.”

“These staggering numbers double if we wait for two years.”

“We believe it is critical to provide patients with access to highly effective treatment to cure HCV infection without delay in order to diminish future HCV-related morbidity and mortality,” added Professor Sievert.