Chronic hepatitis C infection is a major contributor to rapidly rising liver cancer incidence and mortality rates and is now the fastest increasing cause of cancer death.
There are around 65,000
Victorians living with hepatitis C, but only around 1 per cent are receiving
antiviral treatment (Hepatitis Victoria 2016).
This low level of treatment is
one of the main drivers of hepatitis-related liver cancer, liver disease and
poor health outcomes among people living with hepatitis C.
New Treatments In The GP Domain
The release of new direct acting antiviral (DAA) agents for chronic hepatitis C onto the PBS in March 2016 has been a game-changer. The most common forms of chronic hepatitis C are now curable with a simple, oral, once daily regimen for a usual duration of 12 weeks, and with a low side-effect profile.
Australia is a world leader in making these treatments accessible to all clinically eligible patients who have a Medicare Card. This has created the potential to eliminate chronic hepatitis C as a public health issue by 2030.
GPs At The Forefront Of Treatment Uptake
GPs are a crucial
and essential link in the chain of healthcare providers.
Their position in the primary care setting assists in breaking down barriers of
stigma and adverse perceptions of previous complex, low cure regimens in
tertiary settings.
GPs are in the prime position to identify, screen, and now prescribe safe,
effective, affordable therapy to make that elimination goal a reality for our
community.
Support And Information At HealthPathways Melbourne
Chronic hepatitis C is the second most viewed page on HealthPathways
Melbourne, a website used by general practice teams at
the point of care.
Log on to HealthPathways
Melbourne to access evidence based advice on the screening, management and
local referral options for chronic hepatitis C, including updated information
on the new treatments available on PBS, and links to local specialist support
services and training options.
Or click here
to request access.
PBS prescribing guidelines
Initially, to
prescribe DAA on the PBS, all GPs needed to consult with a gastroenterologist,
hepatologist or infectious diseases physician experienced in the treatment of
chronic hepatitis C infection.
In recognition of the expertise being acquired by many GPs this restriction was
relaxed in October 2016 to allow that a medical practitioner experienced in the
treatment of chronic hepatitis C infection can treat patients (without the need
to consult those specialities).
When is a GP experienced in treatment of chronic hepatitis C?
The PBS position on
applicability of specific restriction criteria (such as being experienced in the
treatment chronic hepatitis C infection) is that this decision is a matter for
the professional judgement of the medical professional at the time of writing
the prescription.
Prescribers are obliged to satisfy themselves that the patient
is eligible to receive treatment under the PBS.
As such, the prescriber needs to
determine whether they are experienced in the treatment of chronic hepatitis C
infection.
For further PBS information and decision matrix for DAA choice see General Statement for Drugs for the Treatment of Hepatitis C.