Treating hepatitis C in New Zealand
22 November 2017
General practice has a real opportunity to significantly lead the way to treat people in the community with the medicines we fund for hepatitis C, but we still have some way to go, writes Dr Bryan Betty, GP and PHARMAC Deputy Medical Director.
Since 1 July 2016 PHARMAC has been funding exciting new medicines which give people the chance of a hepatitis C cure in as little as 12 weeks of treatment; Viekira Pak is available for the approximately 55% of people who have genotype 1(a or b) and Harvoni is available for all people with hepatitis C with end stage liver disease.
Around 2,300 people with hepatitis C have accessed funded treatment to date with Viekira Pak, but we believe there are around 9,000 more people who could benefit from these potential cures right now. General practitioners can lead the uptake by continuing to provide a safe place for patients to open up about their risk behaviours. From there, getting tested for hepatitis C is straight forward for both patients and practitioners.
As practitioners, we owe it to our patients to offer these treatments and working out who has tested positive for hepatitis C is an important first step. In some cases this may mean having proactive conversations with our patients, and looking at ways to identify and treat patients, like what has occurred at The Calder Centre in Auckland, based at the Auckland City Mission.
Dr Richard Davies, a GP at The Calder Centre, says the key to treating hepatitis C is getting everyone in the practice involved.
“Everyone should be doing opportunistic testing, but time pressures, patient loads and competing health needs can mean other areas are prioritised over hepatitis C treatment,” says Dr Davies.
“At the Calder Centre we’ve worked hard to raise awareness of hepatitis C amongst all staff. This allows practice nurses and receptionists to take the lead to be proactive with the identifying and testing of patients that may not have otherwise been highlighted as high risk.
“Team work with other parts of the health sector is also vital. We’ve worked closely with our local pharmacy as well as the NZ Liver Transplant Unit based at Auckland DHB to make sure we’re providing the best opportunity for our patients to get well.
“50% of people who have hepatitis C don’t know they have it. If we’re not proactively taking the lead to get people tested and onto treatment early, we’re doing a disservice to our patients and our community.
DHB prescription breakdown
|Prescriber category||District Health Board||Patient numbers|
|General practitioner||Bay of Plenty||65|
|General practitioner||Capital Coast||51|
|General practitioner||Counties Manukau||12|
|General practitioner||Hawkes Bay||8|
|General practitioner||Hutt Valley||22|
|General practitioner||Nelson Marlborough||43|
|General practitioner||South Canterbury||2|
|General practitioner||West Coast||7|
|Secondary care||Bay of Plenty||75|
|Secondary care||Capital Coast||108|
|Secondary care||Counties Manukau||121|
|Secondary care||Hawkes Bay||82|
|Secondary care||Hutt Valley||47|
|Secondary care||Nelson Marlborough||81|
|Secondary care||South Canterbury||37|
|Secondary care||West Coast||27|
Practices around the country are finding ways to be proactive and test and treat their patients and this is shown in the data. For the good of our patients, we need to build on this foundation and keep the momentum going to do even more.
For patients, there are many benefits from having access to these treatments in the community. It means they can get the level of expert care they expect, but in a place closer to where they live, in a setting that is more comfortable and with a lot less stress – which is important when already having to deal with a difficult clinical situation.
PHARMAC has worked with BPACnz, The Goodfellow Unit and Kineo to support the development of resources for general practitioners to feel even more confident about treating hepatitis C in the community. They’re available on the PHARMAC website.
For the benefit of the community, and New Zealand as a whole, we need to be taking this opportunity and making the most of these new medicines.
Infographic: Looking at hepatitis C in New Zealand (estimated numbers)
- An estimated 50,000 people have hepatitis C in New Zealand
- 20,000 (approximately) have been diagnosed with hepatitis C
- 11,000 (approximately) could have a diagnosis of hepatitis C, genotype 1, and can access funded treatment with Viekra Pak through their GP in the community right now
- Just over 2,000 people with genotype 1 have had funded treatment
- Which means approximately 9,000 people haven’t accessed funded treatment yet.
Last updated: 1 February 2019