Time For Action to prevent lives lost to viral hepatitis.

An urgent call for government action to better equip half a million Australians living with viral hepatitis in combating life-threatening liver disease has been issued by peak health groups.

Calling for increased testing, improved access to liver check-ups and rapid access to new therapies, Hepatitis Australia and the leading state and territory hepatitis organisations warn that 1,000 Australian lives are lost each year due to hepatitis-related liver disease, and without urgent action, deaths from viral hepatitis will increase.

Speaking on World Hepatitis Day (28 July), Hepatitis Australia CEO, Helen Tyrrell said that Australia must never lose sight of the fact that hepatitis B and C are preventable, treatable liver health conditions.

“Chronic hepatitis B and C are liver-destroying viruses that affect half a million Australians – that’s one Australian for every 40 people, more people than the combined populations of Canberra and Darwin – yet only a fraction of these people are being monitored or treated,” she said.

"2015 has been a watershed year in the fight against viral hepatitis with a Federal Government inquiry into Hepatitis C, an advisory committee recommendation for the Government to subsidise new generation hepatitis C interferon-free therapies and improved access to hepatitis B medicines.

“However without urgent action, Australia risks squandering a huge opportunity to help half a million Australians living with chronic hepatitis B and C – that’s why we’re launching our Time For Action campaign today,” said Ms Tyrrell.

The Time For Action campaign aims to highlight the simple but positive actions individuals, communities, healthcare providers and governments can take to combat viral hepatitis.

With a call to ‘get tested, have a liver check-up, and ask about treatment’, the campaign aims to encourage Australians living with chronic hepatitis to protect their liver health. It also includes a call for governments to increase access to liver health services and new treatments and achieve the targets set in the National Strategies.

“It is essential that communities stand shoulder-to-shoulder with people living with hepatitis to ensure we prevent, test, monitor and treat hepatitis B and hepatitis C at every opportunity,” Ms Tyrrell said.

The Time For Action campaign coincides with the release of new research findings from people impacted by hepatitis B and C which identifies significant barriers to testing, liver check-ups and treatment, including negative community attitudes and stigma which deter many people from seeking medical help.

Respondents to the Galaxy Research survey expressed frustration about general practitioners’ lack of knowledge and understanding of hepatitis and long waiting times to see specialists. Sixty-one per cent of those surveyed cited the prohibitive cost of new generation hepatitis C treatments not yet subsidised by the Federal Government as a major barrier to undergoing treatment.

Hepatitis Australia said that Australia needs to use all the tools at its disposal – from hepatitis B vaccination, needle and syringe programs, liver check-ups and antiviral therapy – to reduce the burden of chronic hepatitis B and C.

Pointing to survey respondents’ comments that they wait the best part of a year for liver clinic appointments and are ‘sick and tired of being told to hang in there’ until their liver fails or they develop liver cancer, Ms Tyrrell said governments need to hear the message ‘loud and clear’ that it’s time for action. 

“Many Australians living with hepatitis B and C would like nothing more than to act and start treatment, but many have excessive waits for liver clinic appointments and the new generation of hepatitis C medicines remain out of reach. Now is the time for the Australian governments to set limits on liver clinic waiting times, support expansion of community based hepatitis health services and subsidise new hepatitis C treatments,” Ms Tyrrell concluded.

Click to watch the #TimeForAction video >

Liver cancer records worst ‘death-to-incidence ratio’ – new analysis

Cancer of the liver looms as Australia’s greatest cancer challenge, with new analysis revealing that liver cancer has the highest ‘death-to-incidence ratio’ – indicating shorter average survival – of any cancer in Australia.

Latest Australian Institute of Health and Welfare data analysed by Hepatitis Australia reveals that the number of new cases of liver cancer each year (1,446) is matched by the number of lives lost to the disease (1,419) annually.1 This means that for every Australian diagnosed with liver cancer, another Australian loses their life.

The analysis uncovered that liver cancer had a death-to-incidence ratio of 0.98 (almost one death for every new case), compared with much lower ratios for breast cancer (0.2), prostate cancer (0.16), melanoma (0.13), bowel cancer (0.26), and even lung cancer (0.77). Ratios closer to 0 indicate longer average survival while ratios closer to 1 indicate shorter average survival.

In stark contrast with nearly all other cancers where survival rates have steadily improved over the last two decades, there has been no improvement in liver cancer prognosis.

On World Cancer Day (4 February), Hepatitis Australia’s Acting CEO Kevin Marriott said that untreated viral hepatitis is the leading cause of primary liver cancer in Australia, while liver cancer is now the fastest increasing cause of cancer death in Australia.

“The current situation is like running water into a bath with no plug. New patients are pouring in at the same rate that lives are being lost. The only change is that the water flow is getting stronger every year,” he said.

 “Waiting for a diagnosis of liver cancer is a flawed strategy. A third of Australians with liver cancer die within a month of diagnosis. This is appalling when we know that the prevention and treatment of viral hepatitis could prevent liver cancer and save many lives.

“Australia urgently needs greater investment in programs that prevent viral hepatitis – such as community awareness programs, needle and syringe programs and hepatitis B vaccination – along with improved early diagnosis and timely hepatitis treatment to stop liver cancer developing,” said Mr Marriott.

Without a major increase in the treatment of the blood-borne virus, experts predict a 245 per cent increase in liver cancer from hepatitis C alone by 2030. Currently, only 1 per cent of the 233,000 Australians living with hepatitis C are treated each year.

Hepatitis Australia warned that the liver cancer death rate would be even higher by 2030 when hepatitis B was taken into account. More than 225,000 Australians are living with hepatitis B, but only half are diagnosed and only five per cent are treated.

Associate Professor Ben Cowie from Royal Melbourne Hospital said, “Healthcare professionals need to be on the lookout for Australians who are living with undiagnosed hepatitis B or C and ensure that all Australians living with viral hepatitis receive regular liver check-ups and timely treatment.

“Despite the hepatitis B vaccination being the closest thing we have to a liver cancer vaccine – along with treatment for hepatitis B and C – many adults at high risk of hepatitis B are still ineligible for government vaccination and treatment rates for both hepatitis B and C remain low,” said Associate Professor Cowie.

Cancer Council NSW’s Medical Director, Associate Professor Monica Robotin said “We strongly back efforts to prevent and treat viral hepatitis as a cancer prevention strategy. Federal, state and territory governments need to do more to ensure Australians living with hepatitis B or C are treated to prevent more Australians developing liver cancer.”

 Reference:

1. Australian Institute of Health and Welfare (AIHW). Australian Cancer Incidence and Mortality (ACIM) books. Last updated January 2015. Available at http://www.aihw.gov.au/acim-books/ 

 

The Mortality-to-Incidence Ratio (MIR) is calculated based on the number of deaths from the cancer in question in a given year divided by the number of new cases of that cancer in the same year. The MIR is considered to be a rough measure of the fatality of the cancer in question: if no-one ever died of the cancer the MIR would be 0 while if everyone died on the same day they were diagnosed the MIR would be 1. So values of the MIR closer to 0 indicate longer average survival while values closer to 1 indicate shorter average survival. 

Three new Hep C treatments on the PBAC agenda for March

On Christmas Eve the Pharmaceutical Benefits Advisory Council released its agenda for the March 2015 meeting. Among the list of medicines to be considered for listing on the PBS are four treatments for hepatitis C. These include:  

  • asunaprevir (BMS) for the treatment of chronic genotype 1b hepatitis C;
  • daclatsavir (BMS) for the treatment of hepatitis C;
  • ledipasvir + sofosbuvir (Gilead) for the treatment of chronic hepatitis C, genotype 1; and
  • sofosbuvir (Gilead) for treatment of hepatitis C (this was previously rejected by PBAC)

In addition, Ribavirin (Clinect) is on the agenda for the treatment of hepatitis C
genotypes 2 and 3 in combination with sofosbuvir)

PBAC is again seeking submissions from the community to inform their discussions and recommendations.  You can find out more about lodging a submission here

Submissions close on the 11th February 2015

If you require any support in preparing a submission you can contact your local hepatitis organisation by calling 1300 437 222 after the 5th January 2015.