Access to new treatments
On March 24, multiple provinces announced they would begin footing the bill for the first once-daily, single tablet regimen for the treatment of chronic hepatitis C virus (HCV) genotype 1 infection in adults, a combination of two drugs – ledipasvir and sofosbuvir (Harvoni™), produced by Gilead Sciences Canada Inc.. Hepatitis C is a significant health issue in Canada. The Public Health Agency of Canada has reported that approximately 1000 deaths each year can be attributed to hepatitis C.
“With at least 250,000 Canadians living with hepatitis C and new drugs available that allow for over 90% cure rates, AHC is thankful that many provinces and the Yukon recognized the importance of adding these lifesaving drugs to their formularies,” commented Patricia Bacon, Chair of AHC. “Getting these drugs to patients is a first step toward a healthier Canadian community where people living with hepatitis C can access the care they need and the cure they deserve.”
British Columbia, Ontario, Manitoba, New Brunswick, and the Yukon have announced that the drug will be covered, following negotiations that saw the provinces and territories working together through the pan-Canadian Pharmaceutical Alliance (pCPA) to reach an agreement to make the new drugs more affordable. Prices agreed upon are being kept confidential. With the exception of Quebec, who is negotiating separately, the other provinces and territories are involved in this negotiation as well and their decisions are expected shortly.
New treatments much more tolerable
Treatment protocols for hepatitis C used to include the drug interferon, and involved repeated injections for up to 48 weeks, with severe side effects for many people, and resulting in cure rates of less than 60%. New drugs that have 94-99% cure rates, few side effects, and a treatment time of as few as eight weeks were approved by Health Canada in 2014, but the price tag (starting at $86,000) kept the treatment out of reach for most.
Treatment criteria still emerging
While an outline of specific treatment criteria is still pending and will likely vary from province-to-province, today’s announcement is certainly an important step toward the elimination of hepatitis C in Canada. British Columbia has announced that eligible patients can apply starting today, and the BC Minister of Health says they expect to treat 1500 BC residents in the first year.
Increased screening for Hep C still needed
Action Hepatitis Canada and its member organizations continue to call for increased Hep C screening, encouraging everyone born between 1945 and 1975 to be tested. Studies show this age group is disproportionally at risk for HCV infection, and as many as 40-70% do not realize they have been infected. People living with undiagnosed Hep C often show no symptoms for years and/or until liver damage is advanced. In 2013, liver specialists reported in the Canadian Medical Association Journal that the best time to be diagnosed and treated is before the individual shows symptoms, resulting in a dramatic decrease in HCV-related morbidity and mortality, as well as a decrease in economic impact. For this reason increased one-time screening is recommended.
About Action Hepatitis Canada
AHC is a national coalition of 35 organizations responding to hepatitis B and C. Our work engages government, policy makers, and civil society across Canada to promote hepatitis B and C prevention, improve access to care and treatment, increase knowledge and innovation, create public health awareness, build health-professional capacity, and support community-based groups and initiatives.
Jennifer van Gennip at email@example.com
12 March 2015 ¦ GENEVA – WHO today issued its first-ever guidance for the treatment of chronic hepatitis B, a viral infection which is spread through blood and body fluids, attacking the liver and resulting in an estimated 650 000 deaths each year – most of them in low- and middle-income countries.
Key recommendations include:
– the use of a few simple non-invasive tests to assess the stage of liver disease to help identify who needs treatment;
– prioritizing treatment for those with cirrhosis – the most advanced stage of liver disease;
– the use of two safe and highly effective medicines, tenofovir or entecavir, for the treatment of chronic hepatitis B; and
– regular monitoring using simple tests for early detection of liver cancer, to assess whether treatment is working, and if treatment can be stopped.
Check the WHO website for the full announcement and guidelines.
Statement from the Canadian HIV/AIDS Legal Network (a member organization of AHC):
We believe in health, human rights, harm reduction, scientific evidence and the well-being of our communities.
Bill C-2, currently before Parliament, undermines all of these by setting out an excessive and unreasonable process for health authorities and community agencies looking to open, or maintain, desperately-needed supervised consumption services (SCS) for people who use drugs.
SCS are health services that provide a safe, hygienic environment where people can use pre-obtained drugs under the supervision of trained staff.
SCS are part of a broader harm reduction approach to substance use. They are not exclusive of drug treatment programs; they are complementary.
SCS are also part of a continuum of care for people who use drugs. They are offered in facilities where nurses and peers work together to provide much-needed care, education and support.
Scientific evidence clearly shows that SCS reduce the risks of transmission of infectious diseases and overdose-related deaths. They improve access to health, treatment and social services for the most marginalized groups and contribute to the safety and quality of life of local communities by reducing the impact of open drug scenes.
The Supreme Court of Canada has recognized that preventing access to such critical health services violates human rights.
We strongly oppose Bill C-2 and ask our elected representatives to reject it and, instead of creating barriers, increase access to evidence-based prevention, harm reduction and treatment services in Canada. Our communities deserve better.
Action Hepatitis Canada was well represented at the recent NCRTP-Hep C 4th Canadian Symposium on HCV held in in Banff, Alberta on February 27th. Nine delegates from the AHC Steering Committee were in attendance. AHC’s visibility was enhanced through an AHC poster, an AHC orientation presentation by Daryl Luster on “The Role of Patient (People) Advocacy in Building a Canadian HCV Action Plan”, and through AHC Chair Patricia Bacon’s participation on the discussion panel following a “debate” between Drs. Curtis Cooper and Jordan Feld addressing the statement, “…that new HCV treatments should only be used on the sickest patients (F2 and above)”.
Watch this web page for a link to the symposium’s presentations which will be available very soon.
Prince Edward Island has announced a hepatitis C management strategy, with $5M set aside to provide the new treatment – Holkira Pak – for Islanders with hepatitis C. The new treatment has a 95 to 100% cure rate, few or no side effects, and a much shorter treatment cycle.
There are approximately 400 PEI residents living with hepatitis C, of which at least 60 are in advanced stages of the disease. Read the full CBC article here.
Following the announcement, André Picard of the Globe and Mail published his opinions, in an article entitled “With Hep C, No Province Is an Island.”
This is good news and corresponds with Action Hepatitis Canada’s call for federal, provincial, and territorial governments across the country to develop strategies to address hepatitis C in their jurisdictions.
AHC is happy to welcome Jennifer van Gennip in the new role of Administrative Coordinator. Jennifer will be working closely with AHC Members, the AHC Steering and Executive Committees, and the AHC Secretariat to help AHC realize its goals.
Jennifer can be reached at: firstname.lastname@example.org.
Dear Members of Action Hepatitis Canada.
During the AHC All-Member AGM/Update teleconference scheduled for January 28th, 2015, Members of AHC will be provided with the list of organizations comprising this years’ Steering Committee.
At present, the following organizations are represented on the AHC Steering Committee, and all have expressed an interest to continue to be represented on the Steering Committee for the next year:
1.Blood Ties Four Directions Centre – www.bloodties.ca
2.Canadian Aboriginal AIDS Network (CAAN) – www.caan.ca/
3.Canadian Association of Hepatology Nurses (CAHN) – www.cahn.ca
4.Canadian Hemophilia Society (CHS) – www.hemophilia.ca
5.Canadian Treatment Action Council (CTAC) – www.ctac.ca
6.CATIE – www.catie.ca
7.Centre associatif polyvalent d’aide hépatite C (CAPAHC) – www.capahc.com/wp/
8.Hep C BC – www.hepcbc.ca
9.Hep NS – www.hepns.ca
10.Manitoba Hepatitis C Support Community Inc. – www.mbhepc.org/main.htm
11.Pacific Hepatitis C Network (PHCN) – www.pacifichepc.org
As the AHC Steering Committee is composed of 8-12 representatives from AHC member organizations, there is potentially room for one more organization on the Steering Committee. The following organization has expressed an interest in joining the Steering Committee:
Canadian AIDS Society (CAS) – http://www.cdnaids.ca/
As the number of organizations expressing an interest in participating in the AHC Steering Committee is less than or equal to the positions available, and unless any further nominations are received by 5 PM eastern time, Friday, January 23rd, 2015 (at email@example.com), the Steering Committee will be acclaimed. If the number of nominations exceeds the positions available, AHC members will be asked to vote between January 23rd and January 27th for their preferred 12 Steering Committee representatives.
To review the “Action Hepatitis Canada Steering Committee Terms of Reference” document, check the AHC website: http://actionhepatitiscanada.ca/.
If you have further questions or comments, please contact Jeff at: firstname.lastname@example.org
For your information, the Action Hepatitis Canada Member Update and Steering Committee Elections teleconference takes place:
Wednesday, January 28th, 2015
2 PM to (no later than) 3:30 PM, Eastern time.
On behalf of the Steering Committee for Action Hepatitis Canada, we look forward to your participation.
Patricia Bacon, AHC Chair
Jeff Rice, AHC Secretariat
Watch for it, launching in February 2015!