Hepatitis C patients are being deprived of medical treatment because authorities fear the €75 million price tag for the drugs would cripple the entire healthcare system, a new report has found.
Ombudsman Joseph Said Pullicino investigated the lack of provision of costly hepatitis C medication, as well as certain diabetes treatments which were being denied for “cost cutting” purposes.
The report found that the hepatitis treatment, Harvoni Regime, would cost the authorities a staggering €75,000 per patient.
There are some 1,000 hepatitis C patients on the island. It can be caught by coming in contact with blood of an infected person and drug users sometimes contract the illness from needle sharing.
At a press conference shortly after the report’s publication, Health Parliamentary Secretary Chris Fearne said he feared providing the medication would affect the financial sustainability of the entire healthcare service.
If we add this medication to the government’s formulary then the price will remain high. If many small states do this together then the price could be negotiated
“The government is committed to providing free medication but not at the risk of exposing the entire system,” he said.
Instead, the government would be banding together with other small EU member states in a bid to lower the price.
“If we add this medication to the government’s formulary then the price will remain high. If many small states do this together then the price could be negotiated,” he said.
The hepatitis medication was added to the schedule of medicines in the Social Security Act back in 2012, however at that time it cost around €18,000 per patient.
The issue of lack of treatment was raised by two hepatitis patients, one of whom contracted the disease when he was given a contaminated blood transfusion by the Health Department some 30 years ago.
The Ombudsman received an expert opinion saying that about 20 per cent of hepatitis C patients would develop liver failure or cancer if untreated.
He said about 35 patients needed to start receiving the treatment as soon as possible. This would cost in the region of €2.6 million.
Dr Fearne, however, said that providing the treatment to these patients only would be discriminatory to those who were not in dire need of it.
In the long run, he said, the government was looking to draft a rare diseases policy to apply in such situations.
Asked if he knew of any other medications not being provided for cost-cutting reasons, Dr Fearne said the government had a “long list of orphan medications” for rare diseases, some of which cost hundreds of thousands of euros per cycle.
Meanwhile, a national diabetes policy will next year amend protocols barring patients from receiving certain treatments, he added.
Dr Fearne was reacting to a separate report by the Ombudsman which found that Type 2 diabetes patients were not being given certain insulin treatments. These were only being provided for Type 1 patients.
The report concluded that this was discriminatory and deprived the patients of their entitlement to treatment.
Dr Fearne, however, said the new policy, expected by the end of the year, would provide oral medication currently not being provided.
The insulin injections for Type 2 would then be rolled out in the months that followed.
Meanwhile, the Ombudsman said patients who needed to have their blood sugar levels tested were only being provided with two testing strips rather than four, the report found.
The required four strips were only being given to patients under the age of 18.
This, the report said, was being done because of protocols set up by the Health Department. The Ombudsman said these protocols might not have been based on purely medical indications and could have been “a tool to refuse treatment because of financial constraints”.
Asked about this, Dr Fearne said he was not aware of any new protocols being drafted which were not based on medical expertise.