Work in progress for improving hepatitis treatment services in New Zealand.
On this page:
- Major advances in the treatment of hepatitis C
- Training and education
- Revised approach to the delivery of hepatitis C services
- Hepatitis C one-off payment
- More information
Hepatitis C is a viral infection affecting over 50,000 New Zealanders, although it is estimated only half are currently diagnosed. Untreated, 20-25 percent will develop cirrhosis, and without successful treatment, 5 -10 percent of those with cirrhosis will progress to life-threatening liver cancer or liver failure every year.
There have been major advances in the treatment of hepatitis C recently announced by PHARMAC. The Ministry has also been working with DHB regions to revise the delivery of hepatitis C services by integrating service delivery across primary and secondary care. More information about both of these developments is outlined below.
On 9 June 2016 PHARMAC announced funding for direct-acting antiviral drug therapies for New Zealanders living with the hepatitis C virus. From 1 July 2016, the following treatments have been fully funded (some with access criteria): Harvoni and Viekira Pak for hepatitis C infection. This announcement is a major advancement in the treatment of hepatitis C, with cure rates of more than 90 percent with 12 weeks treatment.
For the first three months Viekira Pak and Viekira Pak-RBV was listed with a restriction limiting access to funded treatment to infectious disease specialists, gastroenterologists and hepatologists.
From 1 October 2016, all prescribers including general practitioners will be able to prescribe Viekira Pak and Viekira Pak-RBV.
This is the first time general practice will have funded access to these medicines and is a fundamental change in in the treatment of hepatitis C in primary care.
PHARMAC has been working closely with clinicians, the Ministry, suppliers and others in the health sector to ensure that the right information is available to support the treatment of hepatitis C in the community.
Refer to the PHARMAC website for information to support the roll out of the new hepatitis C funded treatments. This includes information from the Best Practice Advocacy Centre, product information, medical information for prescribers and pharmacists, and more details about patient eligibility for funded treatments:
A range of education, training and communication resources have been developed to support implementation and roll out of the new hepatitis C treatments. The Hepatitis C Implementation Advisory Group recently updated their guidance in response to the new treatments:
- Guidance to support the development of regional services to deliver identification and treatment for people at risk of or with hepatitis C (docx, 142 KB)
- Guidance to support the development of regional services to deliver identification and treatment for people at risk of or with hepatitis C (pdf, 286 KB)
To support GPs to become competent prescribers, updates have been made to a hepatitis C e-learning tool first published by the Ministry in 2012. Professor Ed Gane, head of the National Liver Transplant Unit, worked with PHARMAC to update the ‘Hepatitis C Learning Programme’ to provide training and education on the new hepatitis C treatments. More information about the e-learning tool is available on the Ministry’s ‘learn online’ website:
A Best Practice Advocacy Centre (BPAC) resource has been developed to provide prescribers in primary care with comprehensive guidance on the management of patients with hepatitis C.
Prescribing guidance has been completed by the New Zealand Society of Gastroenterology in the form of hepatitis C virus treatment guidelines. These guidelines can be found on the New Zealand Society of Gastroenterology website:
Last year the Ministry of Health began working with the four DHB regions on a revised approach to the delivery of hepatitis C services across New Zealand. This change in approach was in part informed by a Pilot carried out by the Hepatitis Foundation of New Zealand between 2012- 2014 in the Central and Midland regions.
Over the past year, project managers in all four DHB regions set up cross-sector working groups to plan and develop clinical care pathways, identify clinical and diagnostic capacity and capability requirements and develop an implementation plan for integrated service delivery across primary and secondary care.
This work was supported by a clinically led Hepatitis C Implementation Advisory Group who developed guidance covering the high level hepatitis C clinical pathway, minimum requirements, quality assurance frameworks, minimum standards and data collection.
The four DHB regions are now implementing a revised approach to deliver hepatitis C services. These services will provide early identification primarily through non-invasive liver scanning, which where possible is community based; diagnosis; assessment; triage; and management, including monitoring, support and education to people with hepatitis C within the general practice environment.
Since 2006, one-off payments have been offered to individuals who were infected by hepatitis C from blood or blood products where the blood was collected prior to 27 July 1992 and individuals met a number of other criteria.
Most cases where individuals have qualified for the one-off payments have now been agreed and settled. There are still occasional cases, where an individual is diagnosed with hepatitis C and the cause is determined to be due to blood or blood products administered prior to July 1992.
In these instances, individuals would usually be directed to ACC by their health professional as their diagnosis would generally be regarded as a treatment injury.
Within ACC, their case is assessed and if eligible for a one-off payment the individual would be informed and their request subsequently considered by the Ministry of Health.
- Hepatitis C consumer information
- Hepatitis C Resource Centre 0800 224 372
- Hepatitis Foundation of New Zealand
- Hepatitis C e-learning tool for GPs and nurses
Hepatitis A B C
Advice on symptoms, treatment and prevention for hepatitis A, B and C, and general hygiene practices to help prevent spread of these diseases.