Treatment, DAAs, community prescribers
Treatment
- Concise – Clinical Guidance for Treating Hepatitis C Virus Infection: a summary
- In depth – Australian Recommendations for the Management of Hepatitis C Virus Infection: a consensus statement
- TGA Alert – Hepatitis B Reactivation
- HEP Drug Interactions Checker from the University of Liverpool
Update: In April 2020 treatment eligibility was changed:
The requirement to provide the hepatitis C virus genotype at the time of application was removed.
The Population criteria: Patient must be aged 18 years or older was removed.
Additionally, authorised nurse practitioners may now prescribe hepatitis C treatments.
Full details of the changes can be found in the PBS General Statement for Drugs for the Treatment of Hepatitis C.
Prescribing by GPs
- GPs may prescribe direct-acting antivirals. Visit SA Health Community Prescribing for more information.
- Hepatitis SA information portal for hepatitis C treatment prescribers.
Accessing consultation with a specialist for treatment initiation
- The GESA ‘Remote Consultation Request for Initiation of Hepatitis C Treatment‘ form (PDF) can be used by GPs to consult with a gastroenterologist, hepatologist, or infectious disease physician experienced in the treatment of chronic hepatitis C infection, in order to prescribe new treatments under the PBS.
- Alternatively, the ASHM and Kirby Institute REACH-C study has an online form. Specialists highly experienced in HCV treatment will review the form and either approve the treatment choice or request that further information be provided. The anticipated turn-around time is 24 hours. The study aims to evaluate uptake and real-world outcomes of direct acting anti-viral therapy for HCV in Australia and began in March 2016 with no end date announced.
Adherence Support
- Concise – Quick reference – Australasian Hepatology Association consensus guidelines for the provision of adherence support to patients with hepatitis C on direct acting antivirals
- In depth – The Australasian Hepatology Association consensus guidelines for the provision of adherence support to patients with hepatitis C on direct acting antivirals
Script Management & Dose Reminders
Smartphone and tablet apps are available for this purpose. Examples include:
- MedAdvisor – used by Amcal+, Chemplus, Chemist King
- The Chemist Warehouse has their own app
Cost of Medicine
- PBS fees and safety net threshold
- The Closing the Gap PBS copayment measure provides further assistance for ATSI patients
Filling Scripts
A map showing pharmacies known to dispense hepatitis C direct-acting antivirals is available on the Hepatitis SA website.
Online: Patients are able to order online from pharmacies that offer this service if they prefer not to visit a pharmacy in person. However, it is important that they consider how they will manage:
- Temperature control – Medicines shouldn’t be left in a hot mailbox for an extended period. Improperly stored medicines may not be as effective.
- Script continuity – The online ordering process takes time. The script must be posted once the order is placed, the chemist may need to order the medicine from their supplier which may take up to 48 hours and then the medicine needs to be delivered. Missing doses may make treatment less effective.
Special Populations
- Australian Recommendations for the Management of Hepatitis C Virus Infection: Special Populations
This section of the guidelines includes treatment of decompensated liver disease, treatment of HCV after liver transplantation, treatment of HCV in the setting of HIV coinfection, treatment of HCV in the setting of HBV coinfection, treatment of HCV in people with renal impairment and treatment of people with acute HCV infection.