Friday, July 29, 2016

Pharmac puts brakes on hepatitis C drug so GPs can get up to speed

Rollout of a new hepatitis C treatment in primary care has been delayed to allow GPs to fa-miliarise themselves with what is described as one of the biggest changes in general practice prescribing in decades.

New Pharmac-funded medications Viekira Pak and Viekira Pak-RBV were to have been made available nationally from 1 July, for both GP and secondary specialists.

GPs and organisations, including the RNZCGP and NZMA, highlighted the urgent need for training and funding to safely prescribe the drugs. That led Pharmac to delay the drugs’ introduction into primary care until 1 October.

Until then, the drug will be listed with a restriction limiting access to infectious disease specialists, gastroenterologists and hepatologists.

Another newly funded hep C treatment, Harvoni, will mostly be prescribed by hospital specialists rather than GPs.

Pharmac responded to concerns

Pharmac’s deputy medical director for primary care, GP Bryan Betty, says the agency responded to the concerns raised and that is why it decided to delay the rollout.

“I think, from the general practice point of view, this is one of the biggest changes in general practice prescribing in decades,” Dr Betty says.

“This space has traditionally been specialist-only. It’s very significant, the investment in this medication, and the fact it has gone out to general practice. [But] there was a concern flagged over the time frame of releasing this medication into community listing.”

Contraindications with statins and asthma drugs

Dr Betty says GPs need to be familiar with the drug and the work-up of patients, including possible contraindications with statins and asthma drugs such as salmeterol. Testing for genotypes and fibrosis of the liver are also factors to take into account.

Dr Betty says a range of materials and training resources is being made available through the Ministry of Health and on websites, including those of BPAC and Pharmac.

Viekira Pak’s manufacturer, AbbVie, will also be running seminars.

Dr Betty believes GPs will be keen to get involved in the treatments, which have shown suc-cess rates of well over 90 per cent in curing hepatitis C.

“This is a major step forward in terms of hepatitis C treatment and a major step forward for GPs, really. General practice has a responsibility in having access to this medication and allowing patients access to treatment.”

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