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5 things you need to know about the new Hepatitis C medicines on the PBS

5 things you need to know about the new Hepatitis C medicines on the PBS - Featured Image

Four new hepatitis C medications have been added to the Pharmaceutical Benefits Scheme from 1st March 2016, providing new hope for sufferers.

Helen Tyrrell, chief executive officer of Hepatitis Australia, told MJA InSight that new listing meant “exciting times” ahead.

“There is a real opportunity here,” she said. “If we can get the treatment out there, get GPs engaged, there is a real chance of eliminating hepatitis C [as a public health threat] within 10 to 15 years.”

Here are 5 facts you need to know about the new listing.

1. What drugs are listed and how much will they be?

The medicines scheduled for listing on the PBS are daclatasvir (Daklinza®); ledipasvir with sofosbuvir (Harvoni® ); sofosbuvir (Sovaldi® ) and ribavirin (Ibavyr® ). The PBS listing for peginterferon alfa-2a (&) ribavirin (Pegasys RBV® ) will also be amended to allow its use in combination with sofosbuvir.

According to the PBS, these new medicines have a cure rate of greater than 90%. Treatment is also ‘shorter in duration, less complex and much better tolerated that traditional treatments’.

Under the PBS, the treatments will cost $38.30 for general patients and $6.20 for concessional patients.

Related: Jason Grebely & Gregory Dore: Hep C crossroads

2. Who can prescribe them?

To qualify for the PBS subsidy, gastroenterologists, hepatologists, or infectious disease physicians who are experienced in the treatment of chronic hepatitis C will be eligible to prescribe the new medication. General practitioners will still be able to prescribe under the PBS as long as it is done in consultation with a gastroenterologist, hepatologist, or infectious disease physician experienced in the treatment of chronic hepatitis C infection. According to the PBS, this means that the ‘GP must consult with one of the specified specialists by phone, mail, email or videoconference in order to meet the prescriber eligibility requirements.’

Dr Fran Bramwell, a Melbourne GP and the RACGP’s representative on an expert panel which prepared a consensus statement on the soon-to-be-published Australian Recommendations for the Management of HCV Infection admitted to MJA InSight that it will be an adjustment for GPs.

“For high caseload GPs it will be cumbersome in the beginning,” she said. “We will have to see how things develop in the next few months, but GPs have demonstrated time and time again that they are responsible about what medications they prescribe.”

She said she is hopeful that the requirements could be amended in the following months so S 100 prescribers would be able to prescribe the Hepatitis C drugs without a specialist’s approval.

3. What information do doctors need to provide in order to prescribe this drug?

Prescribers will need to provide information about the heptatitis C virus genotype and the patients cirrhotic status (non-cirrhotic or cirrhotic).

The following must be documented in the patient’s records:

  • evidence of chronic hepatitis C infection (repeatedly antibody to hepatitis C virus (anti-HCV) positive and hepatitis C virus ribonucleic acid (HCV RNA) positive);
  • evidence of the hepatitis C virus genotype.

Related: Hep C cure comes with $3 billion price tag

4. Can my patients get a repeat?

The current PBS restrictions don’t prohibit patients receiving repeats or a different course of treatment however it is not supported by current evidence. The Department will review the use of the medicines in the future to ensure value for money for the taxpayer.

5. Where can I get more training/information?

The Department of Health’s have released a Frequently Asked Questions list for Healthcare providers.

The Australasian Society of HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) runs 2-day s 100 prescriber accreditation courses as well as 1-day hepatitis C new treatment courses.

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