H Hepatitis C Treatment Initiative Service description This initiative recognises the need for an intensified and expanded Hepatitis C virus response if we are to eradicate Hepatitis C in the Bay of Plenty. The Hepatitis C Treatment Initiative aims to decrease barriers to treatment for Hepatitis C by funding free access to treatment in primary care. The introduction of the newly funded treatment, Maviret, has simplified treatment of patients in primary care. Approximately 150 patients in the Bay of Plenty have been identified as being exposed to the Hepatitis C virus as part of the PHARMAC recall, carried out in October 2018. These patients should be contacted, diagnosed and tested for suitability for primacy care treatment.
Eligibility criteria â–Ş â–Ş
Patient is enrolled with the WBOP PHO and lives within the Bay of Plenty Patient has been identified through the PHARMAC recall or through health screening
Referrals for patients enrolled with nonparticipating practices For patients enrolled at a general practice which is not participating in the Hepatitis C initiative a referral can be made to the WBOP PHO Health & Wellness Service for assessment and treatment.
Resources APRI calculator https://www.hepatitisc.uw.edu/page/clinical-calculators/apri Medication interaction checker https://www.hep-druginteractions.org/checker Accredited pharmacy list https://maviret.co.nz/find-a-pharmacy/
The three stages to the initiative: Stage 1 - Contact with Patient Multiple attempts to contact the patient may be needed to engage the patient with an appointment. The WBOP PHO will compensate for the time spent contacting the patient with this claim.
Stage 2 - Pre treatment Assessment The purpose of Stage 2 is to ensure suitability for primary care treatment through clinical examination and assessment. Full clinical assessment guidelines are available through the Midland Region Community Health Pathways https://midland.communityhealthpathways.org/index.htm Printed resources for patients and clinical staff are available from Abbvie https://maviret.co.nz/ Refer to secondary care if there is: Cirrhosis, coexisting HBV/HIV, eGFR <30, complex medication regime or a previous failed treatment.
Stage 3 - Treatment and follow up The purpose of Stage 3 is to ensure safe administration of medication and follow up during and after treatment. In this stage, suitability for primary care treatment needs to be confirmed, medication is prescribed, and the patient is given medication and pharmacy information (see resources above). â&#x20AC;˘
Follow up 1: 4 weeks into the treatment, contact should be made to check adherence and side effects. This could be a phone call or a consultation with either a nurse or a doctor.
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Follow up 2: 12 weeks after the treatment is completed a test of cure must be done. HCV RNA and liver function tests will need to be completed.
Payment ▪
Package of Care (PoC) $368.00 including GST, available per patient in the following stages: Stage 1 – Contact with Patient $57.50 incl GST Stage 2 – Pre-treatment Assessment $253.00 incl GST Stage 3 – Treatment and Follow up $57.50 incl GST
Claiming • •
This is currently a manual process. Invoices should be submitted to the WBOP PHO. At each stage, an invoice can be made, irrespective of whether the patient continues to the next treatment stage. • Invoices need to include: 1. Name of GP providing service 2. NHI of each patient that the invoice relates to 3. Date of consultation or other activity 4. Stage of treatment 5. Value claimed
Reporting A reporting spreadsheet will be sent to the Practice Manager each quarter to monitor the progress of treatment and cure of Hepatitis C. This should be completed and returned to WBOP PHO each quarter by the following dates: 20th October, 20th January, 20th April and 20th July of each year.
Please Note: No patient co-payment is to be charged
Contact details: Catherine Warren General Practice Liaison Phone: 07 577 3264 Fax: 07 577 3191 Email: catherinew@wboppho.org.nz