Everybody’s talking about the new Hep C wonder drugs. Here’s the skinny on how to get your hands on them.
Go to your doctor or General Practioner (GP)
First get a hold of any previous liver tests/blood work you may have already had done. This will speed things up.
*If you haven’t had your bloods done in a while you will unfortunately need to get them done again.
A lot depends on your selection of GP. Some GPs will be prepared to handle your treatment themselves (quicker), others may refer you on to a hospital or clinic (slower).
*We have been informed that St Vincent’s liver clinic waiting list is now down to a 2 week waiting list instead of the usual 6 weeks it has been in the past.
Because the new treatments have only been available for a few months, you may still encounter some doctors who are not quite up to speed. In this case it may be worth looking elsewhere.
*Check out our “Hep C Med Prescribers” page (http://hrvic.org.au/hep-c-med-prescribers/) for a list of prescribing doctors that we know of. If your doctor has prescribed it for you, let us know so we can add to the list to help out someone else or if you are a doctor who would like to be added to the list, please contact us here at HRVic.
If your GP already operates out of a community clinic, there is a good chance a visiting gastroenterologist will be able to take over your treatment.
All Australians over the age of 18, whether you are currently using drugs or not , whether you have been treated previously or not, are eligible for treatment.
Being on methadone or suboxone will have no effect on your treatment.
Be certain to tell your treating physician if you are currently taking any alternative or complementary medicines.
If you or your doctor would like to check whether the medicine you are taking will cause any complications to your treatment, you can check here: http://www.hep-druginteractions.org/
Whether you attend a hospital clinic, a community-based clinic or just a GP, the next step will be blood tests (if you have not had them done already). Even if you have had them done in the past year, its best to have them re done to make sure you still have the Hep C virus.
These will determine if you still have the Hep C virus, the kind of Hep C you have (the genotype), the amount of virus in your blood (the viral load) and the level of inflammation in your liver (as shown by levels of the enzyme ALT).
After this, you will be sent for a fibroscan and/or ultrasound – these are non-invasive procedures which show the level of fibrosis in your liver.
The results of these tests will guide your physicians in choosing which medications should make up your treatment.
Once the results are in
If your GP is handling your treatment themselves, they will consult with a gastroenterologist over your results and arrive at a treatment plan. This is not something that requires your attendance. Your doctor will need to call or fax a ‘remote consultation’ document to the liver specialist. It may take a week or possibly a little longer to get the fax looked at by the specialist and returned to your doctor signed off.
(If you are taking the hospital/clinic route, your gastroenterologist will obviously handle everything themselves.)
Next, you will be prescribed a course of drugs. This will consist of either one pill you will need to take daily.(Some genotypes may need more than one type of pill per day-the doctor and specialist will work this out using the GESA Australian recommendations for the management of hepatitis C virus infection: https://www.asid.net.au/documents/item/1208)
The course of treatment will usually last either eight, twelve or twenty-four weeks.
If you have severe fibrosis or cirrhosis, your treatment is likely to be twenty-four weeks and to include an extra drug (ribavirin).
Medications are purchased at pharmacies at normal PBS prices. (Ie. $6.10 concession and approx $38.00 full price)
Please Note: Make sure you let your pharmacy know that you will be arriving with a Hep C medication prescription. These drugs are very expensive for the pharmacists to get in and will sometimes take up to one week to stock. Remember this also when you need to pick up your next 4 weeks dose as you don’t want to take a break in taking your daily tablets or this could compromise your treatments success!
During treatment you will have further blood tests to make sure the medication is working- usually at 4 weeks, 12 weeks and then approx.3 months after treatment’s end to make sure the virus has not returned.
The clearance rate is between 95% and 98%. However like any treatment, there will ALWAYS be the unlucky few who don’t clear the virus the first time around. If this is you- PLEASE don’t worry too much – there are new, and more potent drugs on the way next year.
Only mild side-effects have been reported for the new Hep c drugs. Some people have complained of a headache or nausea in the first week or two of commencing the treatment and some have experienced tiredness.
If you do experience unexpected side effects, please see your doctor immediately.
*Ribavirin is the only current Hep C medication with significant side effects. It can reduce your red blood cell count, causing a (usually) mild form of anaemia which may limit your physical activity. (As mentioned above, this drug is generally only prescribed if your fibrosis has developed into cirrhosis.)
**In the unlikely event that you are prescribed Simeprevir®, you may have to avoid the sun, exposure to which may cause skin rashes.