Since March 2016, direct acting antivirals (DAAs) to cure hepatitis C have been available under the Pharmaceutical Benefits Scheme (PBS) in the community and in outpatient settings, via the General Schedule (s85) or the Highly Specialised Drugs Program (s100). However, existing regulation prevents those in hospital inpatient settings from accessing PBS subsidies for DAAs.
Inpatient stays are an important opportunity for hepatitis C testing and treatment. While hospital inpatients can be prescribed non-PBS scripts, the high cost of DAAs (currently over $30,000 for a single course of treatment) means that hospital budgets and policies may limit the ability of a hospital to pay for DAAs while the patient is admitted, and the hospital may instead wait until the patient has been discharged or is an outpatient to prescribe DAAs under the PBS. This disproportionately impacts patients who are long-stay inpatients, such as those on psychiatry wards. After being unable to access treatment during an inpatient stay, many people with hepatitis C are lost to follow-up in the transition to outpatient settings and do not complete treatment.
Alongside Hepatitis Australia, the Burnet Institute and other organisations in our sector, ASHM is advocating for policy reform to enable access to DAAs for this group. The evidence summary here, prepared by the Burnet Institute, outlines the issue and potential policy solutions in detail.
