New drugs for the treatment of hepatitis C – Frequently Asked Questions for patients

What is hepatitis C?

Hepatitis C is an infectious disease that attacks the liver, causing its inflammation, and may lead to cirrhosis, end stage liver disease, liver cancer, and in some cases death. For more information on Hepatitis C, please visit our Hepatitis C fact sheet.

What are genotypes and do they matter?

Six different genotypes of hepatitis C have been identified. Genotypes 1 and 3 are the most common causes of hepatitis C in Australia and make up 90 per cent of all cases. They are important because they help determine the treatment you need. Unlike in the past, however, your genotype is not important in terms of the chance of cure. With the treatment drugs, all six genotypes have a very high chance of cure.

What causes hepatitis C?

Hepatitis C is caused by a blood borne virus and can be transmitted by infected blood through exposure to contaminated blood products, breaches in infection control in health care settings, mother to child transmission, unsafe tattooing or body piercing practices, or sharing of injecting equipment.

How many Victorians are affected by hepatitis C and who is affected?

Hepatitis C is the most common blood borne virus in Australia with approximately 230,000 people currently living with hepatitis C in Australia and around 65,000 in Victoria.

The population most at risk of acquiring hepatitis C are people who currently inject drugs including people from Aboriginal and Torres Strait Islander and culturally and linguistically diverse backgrounds, prisoners, older people, and young injectors and/or new initiates to injecting drug use.

What are the new hepatitis C treatments and when will they be available?

Recent advances in antiviral treatment have led to the development of new highly effective drugs for the treatment of all types of hepatitis C.

The new hepatitis C treatments are sofosbuvir with ledipasvir (Harvoni); sofosbuvir (Sovaldi); daclatasvir (Daklinza); and ribavirin (Ibavyr).

These new treatments will be available on the Pharmaceuticals Benefits Scheme from 1 March 2016.

Why are the new hepatitis C treatments better?

The new treatments are highly effective with a cure rate of 95-97 per cent. Treatment time is reduced to 12 weeks, drugs are tablets (rather than injections) and there are very few side effects.

This is a major change from just a few years ago, when hepatitis C treatment time was from six to twelve months, with toxic side effects, and only a 50 percent chance of being cured.

This means that people newly diagnosed with hepatitis C, as well as those who have been living with chronic hepatitis C for many years, will now have access to a fast, effective and well-tolerated cure.

See our video: Hepatitis C Cure - what it means for Victorians

What does treatment with the new drugs involve?

The drugs are easy to take and are taken orally.

Treatment time is usually 12 weeks. However this may range between 8 and 24 weeks for a complete course of treatment, depending on the patients genotype, whether the patient has cirrhosis, treatment history and which of the drug combinations the prescriber chooses to use.

Who will be able to access the new drugs? Are there any restrictions?

The new drugs are available to all people 18 years and older. People under 18 years of age with hepatitis C should stay in touch with their GP, or contact the Royal Children’s Hospital.

Can injecting drug users access the new drugs?

Yes, there are no restrictions linked to former or current injecting drug use.

How much will it cost patients to access the new drugs?

The Pharmaceutical Benefits Scheme listing means that hepatitis C patients will only pay the normal co-payment for the new drugs. The co-payment is currently worth $6.20 for patients with concessional healthcare cards and $38.30 for general patients without concessional healthcare cards, per drug, per month. For some patients needing three drugs, for example, the co-payment will therefore be $114.90 per month, or $18.60 per month concession.

More information on co-payment charges can be found on the Commonwealth Department of Health’s website

Who can prescribe the new drugs?

A section 85 listing on the Pharmaceutical Benefits Scheme will allow general practitioners, as well as specialists, to prescribe the new treatments. This means that people with hepatitis C will be able to be treated by a general practitioner in the community. However, people with more advanced care needs, such as cirrhosis, may still need to see a specialist.

Will a specialist need to be involved?

In order to prescribe, general practitioners including physicians with expertise in viral hepatitis, will be required to first consult with a gastroenterologist, hepatologist or infectious diseases physician to ensure patients with liver disease or other complex needs are appropriately referred to specialist care. A face to face consult with the specialist is not required and patients with complex needs will likely be referred to specialist care where appropriate.

Patients affected by hepatitis C with severe or advanced liver disease may still need to access the treatments under the care of a specialist - such as a gastroenterologist, hepatologist, or an infectious disease physician with experience in treating chronic hepatitis C infection.

Will community pharmacies be able to dispense these new hepatitis C drugs?

Community pharmacists will be able to dispense the drugs. However, because these are new drugs, it may take time for pharmacies to order in sufficient stock to meet demand.

This means that patients may need to wait a couple of days after providing their script for the drugs to be available from their local pharmacy.

Will the drugs be available by 1 March 2016

Although the drugs will be available for prescribing through the Pharmaceutical Benefits Scheme, it may be that not all GPs or pharmacists are fully aware of the new treatments by that date. This means there may be some delay in some areas in accessing the drugs from your local GP. However, the Victorian Government is working with doctors, services and hospitals to ensure these delays are minimised as much as possible.

Can prisoners access the new drugs?

Prisoners and those in custodial settings will have access to the new hepatitis C drugs through existing arrangements within the Pharmaceutical Benefits Scheme Highly Specialised Drugs Program.

Where can I go if I have further questions, or need more information?

• Your local GP and pharmacist can provide you with more information on the new treatments, including if they are right for you.
• The Victorian Government funds a range of community organisations to provide information, care and support to people living with hepatitis C, and on the new treatments. For more information, please visit:
  • Hepatitis Australia's website or their National Hepatitis Infoline on Tel. 1800 437 222
    or refer to the Hepatitis Victoria, PBS factsheets and list of questions to ask your local GP or pharmacist.
• Harm Reduction Victoria Tel: (03) 9329 1500
• Victorian Aboriginal Community Controlled Health Organisation
• Australian Society for HIV, Viral Hepatitis and Sexual Health Medicine
• The Federal Department of Health
• Hepatitis Victoria provides a list of liver clinics and liver specialists in Victoria
• Melbourne Sexual Health Centre Tel: (03) 9341 6200
• Multicultural Health and Support Service
• DirectLine Tel. 1800 888 236 – for information about where to get clean needles and syringes for drug users
• Communicable Disease Prevention and Control Unit, Department of Health Victoria Tel. 1300 651 160
• Education and Resource Centre at Alfred Health