Nurse lobbying for hep C treatment changes

A Nanaimo nurse is part of a group lobbying for expanded PharmaCare coverage for patients suffering from hepatitis C.

A Nanaimo nurse is part of a group lobbying for expanded PharmaCare coverage for patients suffering from hepatitis C.

Fran Falconer, the mid-Island’s only hepatitis support nurse and a volunteer with the non-profit group HepCBC, chaired a public forum in Victoria earlier this month on new treatment guidelines developed by the Canadian Association for the Study of the Liver.

“We hosted the meeting to push the government to make changes,” she said.

Hepatitis C is a disease of the liver caused by the hepatitis C virus (HCV). If left untreated or uncured, it can result in end-stage liver failure, leading to organ transplant or death.

Provincial statistics indicate there are about 64,000 British Columbians currently diagnosed with hepatitis C, of whom about 25 per cent have cleared their infection without treatment, much the way people get rid of a flu virus.

HepCBC, a non-profit organization run by and for people infected with or affected by hep C, estimates about 60 per cent of people with the virus will have a long-term infection that causes no problems or causes levels of liver damage ranging from mild to serious.

Falconer said the group already got one of the things it wants – the province announced this week it has approved PharmaCare coverage for a new drug for hep C genotype 1 patients, which is proven to enhance cure rates.

Without coverage, the drug cost patients about $1,000 per week.

Falconer said the next step is to expand PharmaCare coverage to all patients who want treatment and are unable to fight off the virus on their own.

An HCV patient must prove damage to the liver before the province will cover costs of treatment, she said.

“This is a virus that is attacking the liver,” said Falconer. “Why are we waiting until there is significant damage? The earlier we treat, the less sick people are, so treatment is more effective.”

Treating patients before damage occurs is more cost-effective because caring for patients with health issues resulting from hep C is much more costly, she said.

“An ounce of prevention is worth a pound of cure,” said Falconer. “We want equal opportunity for all patients to access care. When people have diabetes, they get treated. Patients with hepatitis C have to qualify.”

She also wants more people to get tested – advocates believe there are many people infected who don’t know it because they do not have symptoms.

“We call this disease the silent epidemic,” said Falconer.

She said intravenous drug users are not the only population at risk – the virus is spread through direct contact with the blood of an infected person and some baby boomers might have been exposed through blood transfusions, tattoos or piercings.

Dr. Paul Hasselback, medical health officer with the Vancouver Island Health Authority, said anyone who received a blood transfusion before 1990 should be tested, as that’s when hep C screening began.

He said the health authority is not seeing as many “new” cases as it is finding people who were infected when they were younger – symptoms take years to develop – and in recent years, an average of 80 people per year in Nanaimo are diagnosed.

“There’s still probably a significant number who are not aware,” said Hasselback.

He said the Canadian Association for the Study of the Liver’s new treatment guidelines are a reflection of a better understanding of the hep C virus and the health authority does look at these recommendations, although it is up to the province to make funding decisions.

In an e-mail, the Ministry of Health said the province spends more than $100 million per year on prevention, education and treatment of hepatitis C and because many patients will recover from hepatitis on their own, providing pharmaceutical interventions to all who contract it would result in spending millions more unnecessarily.

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