Direct acting antiviral medicines for the treatment of chronic hepatitis C
Page last updated: 15 March 2019
Drug utilisation sub-committee (DUSC)
September 2018
Abstract
Purpose
To review the utilisation of new generation direct acting antiviral (DAA) medicines listed on the PBS for the treatment of chronic hepatitis C.
Data Sources
Data to assess the utilisation of direct acting antiviral therapy was obtained from three sources:
- Prescription dispensing data from the Department of Human Services (DHS) prescription database.
- DHS Authorities data, including information on hepatitis C virus genotype and the cirrhotic status of the patient.
- Aboriginal Health Services data.
Key Findings
- Over the first two years of listing (1 March 2016 to 28 February 2018), a total of 56,356 patients were supplied a DAA medicine. As at 30 April 2018, 58,941 patients had received a DAA medicine. The number of patients treated was more than anticipated at the time when the DAA medicines were first listed.
- There was a high initial uptake averaging 4,400 incident patients per month during the first four months of listing. By December 2017, the number of initiators to DAA therapy had stabilised to an average of around 1,280 patients per month.
- The majority of patients were dispensed the full number of original and repeat prescriptions for their allocated DAA regimen that the prescriber had applied for when seeking an Authority approval. Based on a six-month cohort of patients issued with an approved Authority between 1 January to 30 June 2017, 94.3 percent were dispensed a full course of their approved DAA regimen. While the majority of patients were supplied their full course of treatment, it cannot be determined from the PBS data whether the patient was fully compliant in taking all their prescribed medicine.
- Initially the most commonly prescribed DAA regimen was daclatasvir with sofosbuvir. As at April 2018, sofosbuvir with velpatasvir was the most commonly prescribed regimen.
- During the initial year of listing (March 2016 to February 2017), the DAA regimens were mostly prescribed by specialists (67.7 percent). Over time, the number of general practitioners prescribing DAA regimens had increased. During the first quarter of 2018, the highest proportion of prescribing was by general practitioners (57.0 percent).
