Dalhousie researchers find hepatitis patients often can’t afford treatments
July 28 is World Hepatitis Day. Globally, approximately 500 million people are affected by viral hepatitis. In the Maritimes alone, 8,000 people are infected with hepatitis C, which can lead to cirrhosis, liver failure, and liver cancer.
Prescription and non-prescription therapies to treat hepatitis and manage associated adverse effects are costly. Dalhousie researchers have conducted a study, the first of its kind, to determine how patients with hepatitis manage high drug costs.
Dalhousie researchers assessed the types of medications (both prescription and non-prescription) used by hepatitis patients to treat hepatitis infection and associated health problems. The researchers then looked at how patients managed their medication costs and assessed their tendencies to discuss cost concerns with their physicians or pharmacists. Fifty patients participated in the interviewer-administered survey; 38 per cent had household incomes less than $30,000.
The Dalhousie study underscores that drug costs may limit access to essential medications for patients with hepatitis C, even in a publicly funded health care system. For patients with hepatitis C in Nova Scotia, average monthly drug costs are $1,748; some of those costs are out-of-pocket. The average lifetime cost (i.e., medical costs and economic losses) for an affected person, from the time of hepatitis diagnosis to death, has been estimated at $1 million. More than half of survey respondents, 58 per cent, were concerned about having sufficient money to pay for their medications.
Thirty-two per cent of respondents felt that physicians usually do not consider patients’ concerns about affordability when prescribing medications. Thirty per cent of those surveyed reported borrowing money to pay for their prescriptions. Faced with financial constraints, patients may adopt a range of coping strategies to deal with the out-of-pocket expenses required to access essential drugs.
Coping strategies identified in this study include: asking physicians for free medication samples; requesting a longer-duration supply to reduce the cost associated with filling individual prescriptions; seeking help from pharmacists to buy low-cost substitutes; substituting prescription medications with lower-cost non-prescription products; not filling prescriptions; and taking fewer doses to make medications last longer. Some of these coping strategies pose risks to patients' health.
The study was funded by Green Shield Canada, a not-for-profit corporation specializing in group and individual health and dental benefits programs and administration.
“Our study shows that although we’ve got a very good publicly funded health care system, there are real gaps in it – especially when it comes to out-of-hospital drug coverage.” – Dr. Kevork Peltekian, associate professor of medicine and surgery at Dalhousie Medical School and liver specialist at Capital Health
"All Canadians should have access to the medications they need for healthy living -- including high priced ones. Canada needs a national drug insurance plan. Currently, a patchwork of different programs provides Canadians with coverage for drug expenses, depending on where they work or live, how old they are, or what their illnesses are. The latter is inequitable, does not control drug costs, and cannot always ensure that the right patient gets the right medications." – Dr. Kevork Peltekian, associate professor of medicine and surgery at Dalhousie Medical School and liver specialist at Capital Health
"Treatment of hepatitis C is like running a marathon, but with hurdles to jump over; these patients have to overcome personal issues, social stigma, general misinformation, drug coverage, and six to twelve months of treatment that requires a weekly injection and four to seven pills daily. And in the end, there's only a 50 - 80 per cent chance that the virus will be killed." – Dr. Kevork Peltekian, associate professor of medicine and surgery at Dalhousie Medical School and liver specialist at Capital Health
|Dr. Kevork Peltekian|
- Allison Gerrard, Dalhousie Medical School, 902-494-1789, firstname.lastname@example.org