​​Australia became the first country to make direct-acting antiviral (DAA) therapy available to all patients with HCV independent of stage of fibrosis. Health Minister Sussan Ley, made this announcement just before Christmas in 2015. People living with hepatitis C and their clinicians, now have the opportunity to cure a chronic disease.

 

Monitoring hepatitis C treatment uptake in Australia

The Viral Hepatitis Clinical Research Program – a rapidly expanding area of clinical research and development within the Kirby Institute, University of New South Wales is producing a monthly newsletter reporting on uptake of DAAs in Australia.

The program also focuses on therapeutic research in viral hepatitis – clinical research (including clinical trials forming the main part of the program's work); the recently established viral hepatitis sample repository, HepBank, for molecular virology research; and epidemiological research through data linkage studies and mathematical modelling.

This report summarises data on prescribing to date and provides an insight into the initial phase of the roll-out of DAA therapy in Australia. 

 

Newsletter Issues

Issue 7 - Published in July 2017 – Data on monthly DAA treatment uptake were available up to March 2017. After an initial decreasing trend, the monthly number of DAA initiation has reached a relatively steady pattern since October 2016. The initial decline in treatment uptake was consistent with a “warehouse” effect with a large number of patients in specialist clinics awaiting DAA treatment access initiating treatment in the early months. 

Issue 6 - Published in February 2017 – An estimated 25,890 individuals initiated DAA treatment for chronic hepatitis C virus (HCV) infection during March to September 2016, equating to 11% of the people living with chronic HCV in Australia. The total number of DAA initiations in 2016 (March-December) is estimated to be between 30,390 and 33,390.

Issue 5 - Published in September 2016 – An estimated 18,581 patient PBS initial prescriptions for hepatitis C direct acting antiviral (DAA) were processed for reimbursement during March to July 2016. It is estimated that 12% of total individuals living with chronic hepatitis C in Australia have initiated DAA treatment during March to July 2016. Most individuals (77%) were prescribed under the General Schedule (S85).

Issue 4 - Published in August 2016 – Now with 4 months of data, the Kirby Institute's monitoring of HCV uptake is showing some trends. It is thought that with lag time about 10% of people with chronic HCV may have been treated.

Issue 3 - Published in July 2016 – While the uptake for new treatment for chronic hepatitis C from March to May 2016 is very high, it does not reflect the reimbursement of drugs dispensed, so it will take up to 6 weeks for numbers to flow through.

Issue 2 - Published in June 2016 – The uptake reflected in reimbursements for new treatment for chronic hepatitis C during March and April 2016 in Victoria and NSW are virtually identical, probably reflecting a number of larger tertiary clinics in Melbourne, with high number of patients worked up and ready for treatment.

Issue 1 - Published May 2016 – ​The richness of the data findings of uptake of new treatment for chronic hepatitis C during March 2016 are reflected in this issue with a more detailed analysis of prescribing practices. High level of prescribing are being maintained, with close to 20,000 people on treatment.

 

Real world efficacy of antiviral therapy in chronic hepatitis C (REACH-C) in Australia

The Viral Hepatitis Clinical Research Program also publish uptake and outcomes of new treatment for chronic hepatitis C during 2016 in the REACH-C network – project comprising a national network of diverse clinical services with 1618 individuals initiated direct acting antiviral (DAA) treatment for chronic hepatitis C virus (HCV) infection between March and December 2016.

 

Newsletter Issues

Issue 1 - Published July 2017 – This report provides a detailed breakdown of who is receiving treatment by gender, age, jurisdiction; who is prescribing and the regiments patients are receiving. Key finding: DAA prescription from GPs has increased from 8% to 31% from March to December 2016.