Infections - antivirals therapeutic group review
Two new treatments (Harvoni, and Viekira Pak and Viekira Pak-RBV) were funded. These are major advancements in the treatment of hepatitis C, with cure rates of up to 95%. The funding of these treatments at a list price of $24,363 per bottle is managed through a confidential pricing arrangement.
The data on antivirals
Dr Bryan Betty – PHARMAC’s deputy medical director.
New direct-acting anti-viral drugs are a major step forward for treating hepatitis C, says PHARMAC’s deputy medical director Dr Bryan Betty.
New generation hepatitis C treatments have the potential to significantly reduce the impact of this infectious disease which affects approximately 50,000 New Zealanders.
Until this year, the available treatments for hepatitis C such as interferon injections were difficult for patients to tolerate, because of their side effects, and they had a lower success rate.
This meant that many people with hepatitis C then progressed to end stage liver disease, liver cancer, or required a liver transplant.
The new direct-acting anti-virals like Viekira Pak and Harvoni, represented a breakthrough. These are oral treatments, much better tolerated than previous treatments, and with much higher cure rates – up to 95%.
The problem was that they came at a very high cost. So PHARMAC worked hard with suppliers and with our clinical advisers, to find a way to reduce the cost and identify the people who most needed them. People with advanced disease have funded access to Harvoni, while people with the most common genotype of hepatitis C in New Zealand (genotype 1) have unrestricted funded access to Viekira Pak. Importantly, funded access to Viekira Pak can be initiated by general practitioners, moving care closer to home, taking the pressure off specialist hospital services and, potentially, reducing the number of cases of liver cancer and the demand for liver transplants in future for hepatitis C.
In the first year since funding, more than 2000 New Zealanders have been treated with these new treatments.
The next step is to find ways to identify and treat even more people in general practice and primary care.
New treatments for hepatitis C are well tolerated and there is support available like good training, say health professionals who have been treating patients with the new drugs.
Staff at the Calder Centre in central Auckland have been one of the practices pioneering treatment approaches with Viekira Pak, one of the new direct-acting anti-virals for hepatitis C.
It’s been a successful transition to the new medicine, and the clinic has also established a once-a-week clinic with a specialist hepatitis C nurse to screen patients.
GP Richard Davies says he had no trouble coming up to speed with the new treatment.
“The guidelines and protocols are straightforward,” says Dr Davies. “You have to understand the significance of the blood tests. I would start off by viewing one of Ed Gane’s presentations. It’s very clear and it helps you to know what to do and how to do it.”
Hepatitis nurse Victoria Oliver agrees, and says the medicine is well-tolerated by patients.
“It’s quite amazing really. We have people who have issues with adherence, they are sleeping rough or under bridges. But they take their Viekira Pak and ribavirin. People don’t generally have any problems on it at all.”
And staff are already seeing the results.
“When I started my nursing career there was the shock horror of the blood-borne virus, but now in the later stages of my nursing career, 30 years on, to be able to say there’s a cure, we can offer you a treatment and cure, they’re amazed by that. And when three months after they’ve stopped their medication you can say here’s the laboratory form, there’s no virus, they are just amazed. It’s a very positive thing.”
Pharmacist Anthony Zhang, of Hobson St Pharmacy, has seen significant results in some of his patients.
“As a pharmacist, usually when you dispense pharmaceuticals you’re not really giving people a cure. Hopefully with all the patients that we’ve treated with these medicines , the disease will be gone. And that’s not just helping them, it’s helping the future and stopping them spreading it to other people, so that’s good for the community.”
- Read more about hepatitis C treatments, including links to online training resources
Last updated: 1 February 2019