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Friday, March 24, 2017

News Recap

Well, if you’ve been up to our site and seen the daily news posts you will have seen that new drug access policies have now come into effect in BC and Quebec, as well as Ontario. It looks like the slate is the same for these 3 provinces, and we are listing what’s available in BC so you can make sense of it.  For more information on the expanded access criteria in Quebec see here, and in particular the note from CD.

Limited Coverage Drug Program—Expanded Coverage for Chronic Hepatitis C

New Direct-acting Antivirals

Effective March 21, 2017, PharmaCare covers new direct-acting antivirals (DAAs) for Chronic Hepatitis C (HCV) under the Limited Coverage Drug Program. The complete list of DAAs and their criteria follows:

Drug (Trade Name) Criteria – for genotype
sofosbuvir-velpatasvir (Epclusa™) with or without
ribavirin (RBV)
1, 2, 3, 4, 5 or 6
elbasvir-grazoprevir (Zepatier™) with or without RBV 1 or 4
daclatasvir (Daklinza™) plus sofosbuvir (Sovaldi®) with or without RBV 3
asunaprevir (Sunvepra™) plus daclatasvir (Daklinza™) 1b
sofosbuvir (Sovaldi®) with RBV* 2 or 3
ledipasvir-sofosbuvir (Harvoni®)* 1

*previously covered under the PharmaCare Limited Coverage Drug Program

Effective March 23, 2017, PharmaCare will no longer approve new requests for Holkira® PAK.

A letter and detailed prescriber information regarding coverage of drugs for HCV infections have been mailed to practicing infectious disease specialists, gastroenterologists, and general practitioners who have previously prescribed drugs to treat chronic hepatitis C.

BC PharmaCare will expand access to include patients with less advanced disease (fibrosis scores of F0 or F1) if they have been diagnosed with certain co-existing factors.  All HCV patients with fibrosis scores of F2 or higher also remain eligible for reimbursement.  Starting in 2018-19, BC PharmaCare will provide coverage for any resident of the province living with chronic hepatitis C, regardless of the type or severity of their disease.

Criteria for Expanded Coverage for Adults with Chronic Hepatitis C

As of March 21, 2017, PharmaCare covers treatment-naïve or treatment-experienced adults with chronic hepatitis C (CHC) genotype 1, 2, 3, 4, 5 or 6 who have liver fibrosis stage:

  • F2 or greater (Metavir scale or equivalent) including decompensated cirrhosis, or
  • lower than F2 AND meet one or more of the following criteria:
    • Co-infection with HIV or hepatitis B virus
    • Post-organ transplant (liver and/or non-liver organ transplant)
    • Extra-hepatic manifestations
    • Chronic kidney disease Stage 3, 4 or 5 as defined by National Kidney Foundation Kidney Disease Outcomes Quality Initiative
    • Co-existent liver disease with diagnosis evidence for fatty liver disease (e.g., non-alcoholic steatohepatitis)
    • Diabetes for which patient is receiving anti-diabetic drugs
    • Women who are planning to become pregnant within the next 12 months

To access detailed criteria, Special Authority Request forms, and educational document, visit  www.gov.bc.ca/pharmacarespecialauthority. From the list of drugs, select the drug name.

Other News:
HepCBC was thrilled to get an invitation to a Selkirk College student nurse-initiated seminar in Castlegar, BC March 20, 2017. This was part 2 of our 2017 Road Trip to BC`s Interior. You can read all about it and see the photos here: http://hepcbc.ca/2017/03/24/selkirk-college-student-nurses-bring-hepcbc-ankors-hepatitis-c-info-event/

While expanded treatment is fantastic, Canada still has no national testing strategy, and as we all know from the studies, there are many thousands of Canadians who are infected with hepatitis C and don’t know it. It is REALLY important that these individuals are located, tested and treated! Liberal N.W.T. MP Michael McLeod is calling on the federal government to develop a national Hepatitis C education strategy. He wants Health Canada to step up efforts to educate people about Hep C testing. “This is an issue that’s curable… I’m going to stay on this issue and continue to push the fact that we need a strategy.” Canada needs Hepatitis C testing strategy, says N.W.T. MP

For those of you who unfortunately do not qualify for treatment yet and would like to be treated before 2018-19, there is the option to go to India and get treated there. For $3849 USD (Taxes Inclusive; Air Fare NOT Included), WellSpring Meditour will arrange all you need for treatment in a proper medical centre and with licensed drugs. The cost includes a 7 day stay in a 4 star hotel, 12 weeks of medication, all the tests you will need, and some tours.  The location is Chennai India (formerly Madras) on the Bay of Bengal, and payment is via secure channels.

Coming Up Next Week!

HepCBC will have Info booths at the following: