The arrival of new oral drugs for treatment of hepatitis C will dramatically shift the landscape of therapy from being physician-driven to patient-led, raising questions about best practices for adherence. A White Paper published by Atlantis Healthcare offers a roadmap of the new therapeutic environment for pharma industry, healthcare providers and payors, including clinical insights, non-adherence predictors and proven interventions to improve adherence.
“Adherence is critical and we need to be on top of that,” said Professor David Goldberg, leader of Health Protection Scotland’s hepatitis C programme and contributor to the latest report from the Adherence Research SummarizedTM series. “The new drugs are expensive and there is the possibility that the virus could become resistant if adherence is sub-optimal, so we will need to support people to take the medication.”
Hepatitis C is a virus carried in the blood affecting 170 million people worldwide. It is estimated that nearly 215,000 people in the UK have chronic hepatitis C and there are approximately 10,000 new cases diagnosed each year1. According to the report, while therapy offers the possibility of cure, the majority of people living with hepatitis C do not receive treatment. For those who do start treatment, good outcomes are dependent on a high level of adherence.
Current treatment for hepatitis C involves weekly interferon injections combined with oral drugs. Side effects, include fatigue, headache and depression, are the most common reason for discontinuing treatment. The new drugs are in simple pill form, bypassing the need for injections or frequent hospital visits, and offer shorter duration of treatment and improved effectiveness.
“With the new therapies coming on line, much of the demand for the treatment will come from the patients,” said Dr. Goldberg. “They will hear it’s much easier to take, more effective, has fewer side effects and can be taken without disrupting one’s work.”
However, Dr Christina Jackson, senior health psychology specialist from Atlantis Healthcare cautions there are still a number of barriers to adherence a patient faces. “Research shows that across a number of disease states, levels of non-adherence can be high even where the treatment regimen is simple2“.
According to the report, the greater patient responsibility in hepatitis C therapy will present challenges to the healthcare community, especially when supporting hepatitis C patients who have other chronic conditions. Research reviewed indicates that simple patient-led interventions, including personalized nursing support and supplemental patient education from a health care provider other than the physician, can help increase treatment adherence.
2 Saini et al. (2009)