Hepatitis C Treatment Options Expand in BC

The BC government released an announcement about hepatitis C (HCV) treatment options on Tuesday March 13. It reads, in part*:

Any British Columbian living with chronic hepatitis C now is able to access treatment, regardless of the severity of their disease, Health Minister Adrian Dix announced today. In addition to expanding coverage to all British Columbians, a new chronic hepatitis C drug has been added to the PharmaCare formulary.

“In years past, a hepatitis C diagnosis was a stressful and lifelong struggle,” said Dix. “I’m pleased to share that, as of today, anyone in B.C. living with this now-curable virus will have a choice of several treatment options – all of which are fully funded under PharmaCare.”

The new drug, sofosbuvir/velpatasvir/voxilaprevir, also known as Vosevi, received a positive recommendation from the national Common Drug Review in January 2018. The drug was developed for adult patients with difficult-to-treat chronic hepatitis C that has been unsuccessfully treated with other medications.

“Drug treatments for chronic hepatitis C continue to improve and evolve,” added Dix. “Adding Vosevi to the PharmaCare formulary will ensure that patients have multiple treatment options available to them, which is especially important if a particular drug is not performing to its best ability.”

An estimated 73,000 British Columbians live with this virus. The list cost to the health system for chronic hepatitis C treatment has ranged from $45,000 to over $100,000 per patient, depending on the drug and disease progression.

Approximately one-quarter of those living with hepatitis C in B.C. are undiagnosed and unaware they have the virus. Roughly 24% of hepatitis C patients are able to clear the virus without treatment. However, the remaining 76% of patients will develop chronic hepatitis C. Many chronic hepatitis C patients remain in stable condition for years or decades before the virus may advance. The new all-oral, chronic hepatitis C therapies are highly effective, curing more than 95% of people treated.

If left untreated, chronic hepatitis C can be a life-threatening communicable disease, with serious complications, such as liver failure and liver cancer. Risk and harm-reduction practices are strongly encouraged for those who may be at higher risk for reacquiring the virus after successful treatment, including people who inject drugs, men who have sex with men, and commercial sex workers.

Hepatitis C is the most frequent cause of premature death among reportable infectious diseases in North America, and has become the most frequent cause of premature death among people living with both hepatitis C and HIV.

How will this play out for people with HCV in BC? In response to the government announcement, we asked Pacific Hepatitis C Network (PHCN) for their thoughts and they shared this comment:

“Lifting of restrictions opens up hep C treatment access, but the lifting of restrictions and treatments listed on the formulary aren’t magic. We’re thankful to the BC Ministry of Health for ensuring the necessary foundation is in place to achieve the WHO 2030 targets for hepatitis C elimination. The real work now is ensuring linkages to care for all populations impacted.”

This point about linkages to care is important, especially for those that don’t know they are infected. “Unless you are aware of the activities that put you at risk of getting hepatitis C, you will probably not know you have it. Many people do not have symptoms for 10 to 30 years after being infected” says Hepatitis Education Canada.

What happens next? Help people get informed, get tested and get care. We look forward to working with PHCN and other PAN members to strengthen existing links and building new ones so that all people with HCV in BC may realize the benefits of this announcement.

*Read the entire government announcement.