Funding freeze blamed on ‘significantly increased and unpredicted’ number of claims
The treatment of hundreds of patients with hepatitis C with potentially lifesaving drugs has been abruptly halted due to funding problems.
The national hepatitis C programme has told hospitals not to make any further applications for funding support for patients until treatment numbers are “realigned”.
Just six months into the year, the €30 million allocated by the Government to the programme is virtually spent and treating doctors have been told that only their sickest patients will be approved this year. The programme manager said the new arrangements are interim.
The freeze on funding is being blamed, in internal correspondence seen by The Irish Times, on a “significantly increased and unpredicted” number of claims for reimbursement for hepatitis C treatment in June.
Reimbursement claims for June alone reached €10 million, up from €3 million in January and February.
No further applications for funding are being considered and no further patients will be started on treatment, according to a note to specialists by Michele Tait, the manager of the programme. The measures will also affect patients whose treatment is approved but has not yet started.
More than 600 registered patients, whose treatment has not started, are affected, but doctors say hundreds more have been diagnosed recently and will also be affected. Some have severe cirrhosis of the liver and could die unless they receive treatment or a transplant.
Ms Tait says the new arrangements are interim, and designed to ensure the programme operates within budget and that clinical effectiveness is maintained.
“The rug was pulled from under the feet of some of our clients from one day to the next,” says Nicola Perry, manager of Community Response, an alcohol and liver health service in Dublin’s south inner city. “They are angry, and disheartened. People living with addiction often feel disenfranchised by the rest of society, and this showed that, once again, they don’t matter.”
The freeze has caused concern among doctors treating hepatitis C patients, many of whom are seriously ill and had been given dates for treatment. They were forced to turn away patients who turned up at a scheduled appointment for their treatment.
Dr Orla Crosbie, a gastroenterologist in Cork University Hospital, warned Ms Tait that many of her patients may deteriorate while awaiting therapy. Her patients include a health worker who acquired hepatitis C through a needle stick injury and patients with cirrhotic livers. “Several have been given dates to start therapy, with many changing drugs. Many have made work and care commitments for children to facilitate therapy in the autumn.”
The HSE confirmed new applications were not being taken at present due to an “unprecedented volume of patients being commenced on treatment in May and June”. The programme must operate within its budget, it said.
The realignment of the programme will be concluded within weeks after which new patients prioritised by their doctors will start treatment, a spokeswoman said.
About 30,000 people are living with hepatitis C in Ireland. Most acquired the disease through injecting drugs but 1,300 were infected by contaminated blood products provided by the State.
In recent years, newly developed anti-viral drugs have transformed the treatment of the disease, with cure rates of up to 90 per cent . Prices have dropped as generic versions have come on the market, but treatment still costs more than €20,000 a patient.
Ms Tait says the restrictions would remain in place “until such time as the programme is fully informed on the funding and therefore volume of treatment which is available to the year end”.
By Paul Cullen