A new evidence summary by Burnet Institute has revealed some people with hepatitis C in hospitals are not accessing treatment due to the cost of medication, sparking calls for the federal government to review legislation to improve access.
Published jointly by Burnet Institute, Hepatitis Australia and ASHM, the summary suggests that preventing people in hospital inpatient settings from accessing PBS subsidies for direct acting antivirals (DAAs) to cure hepatitis C meant people were missing out on vital treatment.
Burnet senior research fellow Associate Professor Alisa Pedrana said it was vital that life-saving hepatitis C treatment was made available to everyone, including hospital inpatients.
“We know from previous research that long-stay inpatients, such as those on psychiatry wards or people who are admitted to hospitals for the management of injecting-related infectious diseases, are currently missing out on the opportunity to initiate treatment for hepatitis C while they are in hospital,” she said.
“These people are required to wait to be treated in outpatient services following discharge.”
In a previous study, which evaluated treatment uptake following discharge, only two-thirds of patients requiring treatment for hepatitis C who were discharged from hospital had started treatment.
“Removing barriers to accessing treatment in hospital could help people who would otherwise miss out on this living saving treatment,” Associate Professor Pedrana said.
ASHM CEO Alexis Apostolellis said that while the cost of hepatitis C treatment was high, the cost of not treating people was much higher.
“A single course of direct acting antivirals for hepatitis C is very expensive without PBS subsidies,” Mr Apostolellis said.
“Because people in hospital cannot access PBS subsidies for these treatments, hospitals are required to foot the bill – which in some cases, is not happening. That means people are being told to delay treatment until they are out of hospital, which is leading to people being lost to follow up, and ultimately not accessing life-saving treatments.”
The evidence summary includes potential solutions to this issue, including allowing people to commence Commonwealth-subsidised DAA treatment for hepatitis C in hospital, aligning with exemptions that exist for a limited number of other medicines, and for people in prison.
Hepatitis Australia CEO Lucy Clynes said the change would better position Australia to meet its target of eliminating hepatitis C as a public health threat by 2030.
“If people can’t access treatment for hepatitis C, Australia will not meet its elimination targets,” she said.
“People in hospitals are already connected to healthcare, making them well positioned to start live-saving hepatitis C treatment. Some priority populations for hepatitis C testing and treatment, including people who inject drugs, are more likely to require frequent hospital admission. Removing barriers to accessing treatment can and will have a huge impact,” she said.
Further information and the evidence summary can be accessed via https://ashm.org.au/about/news/hepatitis-c-treatment-access-for-hospital-inpatients/
